Uterine fibroid therapy using interventional radiology mini-invasive treatments: current perspective.
OBJECTIVE The purpose of this article is to compare uterine peristalsis before and after uterine artery embolization (UAE) on a 3-T MRI system. SUBJECTS AND METHODS MRI scans were prospectively performed for 20 women with symptomatic uterine fibroids (age range, 39-53 years) before and after UAE in the periovulatory phase with a 3-T scanner. Sagittal T2 turbo spin-echo sequences and a HASTE sequence were obtained. Sixty HASTE images were obtained for 3 minutes to display on cine mode. Two radiologists independently evaluated the datasets for the presence of uterine peristalsis using a 5-point rating scale. When peristalsis was present, the direction and frequency were recorded. The images were also evaluated for index fibroid location before and after UAE, index fibroid volume, uterine volume, and fibroid burden estimate. RESULTS The presence and frequency of uterine peristalsis increased after UAE for both readers, but was significant only for the presence of uterine peristalsis. The majority of patients had peristalsis in the cervix-to-fundus direction. In six cases, uterine peristalsis emerged after UAE. Uterine volumes before UAE were significantly smaller in these six cases compared with the remaining 14 cases, though no significant difference was found in the reduction rate of the uterus or fibroid volumes. The index fibroid was intramural in three of the six cases with interval appearance of peristalsis. The fibroid was solitary in four of the six cases. CONCLUSION Cine MRI at 3 T may show recovery of uterine peristalsis in some women with symptomatic fibroids after successful UAE.