Degeneration of leiomyoma in patients referred for uterine fibroid embolization: incidence, imaging features and clinical characteristics.

Content Provider	Europe PMC
Author	Han, Seung Chul Kim, Man-Deuk Jung, Dae Chul Lee, Myungsu Lee, Mu Sook Park, Sung Il Won, Jong Yun Lee, Do Yun Lee, Kwang Hun
Copyright Year	2013
Abstract	PurposeImaging features and clinical characteristics of degenerated leiomyoma in patients referred for uterine fibroid embolization (UFE) were analyzed to assess the incidence of degenerated leiomyoma.Materials and MethodsPatients referred for UFE between 2008 and 2009 were retrospectively analyzed (n=276). Patients ranged in age from 27 to 51 years (mean 38.0 years). All patients underwent screening MRI with contrast enhancement. Medical histories and clinical symptoms were evaluated.ResultsAmong the 276 patients who underwent MRI, 14 (5.1%) showed degenerated leiomyomas. Symptoms were abdominal pain (n=4, 26.7%), menorrhagia (n=5, 35.7%) and bulk-related symptoms (n=5, 35.7%) and no symptoms (n=5, 35.7%). Of the 14 patients with degenerated leiomyomas, 5 (42.9%) had a history of pregnancy in the past two years. For T1-weighted imaging (T1WI), a high signal intensity (SI) of the leiomyoma was the most common finding (n=9, 64.3%) and a hyperintense rim (n=4, 28.6%) was the second most common. On T2-weighted imaging (T2WI), a low SI of the leiomyoma was found in six patients (42.9%), a high SI in four (28.6%) and a heterogeneous SI in four (28.6%) patients. Conservative management was performed in 11 (78.6%) patients, surgery in 3 (21.4%) and uterine artery embolization in one (7.1%) patient.ConclusionThe incidence of degeneration of leiomyoma in patients referred for UFE was 5.1%. Patients presented with variable clinical symptoms with or without a history of pregnancy. MR imaging showed a high SI on T1WI and various SIs on T2WI without contrast enhancement. An understanding of the degeneration of leiomyomata is essential when considering UFE.
ISSN	05135796
Volume Number	54
PubMed Central reference number	PMC3521269
Issue Number	1
PubMed reference number	23225822
Journal	Yonsei Medical Journal [Yonsei Med. J]
e-ISSN	19762437
DOI	10.3349/ymj.2013.54.1.215
Language	English
Publisher	Yonsei University College of Medicine
Publisher Date	2013-01-01
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © Copyright: Yonsei University College of Medicine 2013
Subject Keyword	Uterine artery embolization magnetic resonance imaging degeneration leiomyoma uterus
Content Type	Text
Resource Type	Article
Subject	Medicine