Burn P R, McCall J M, Chinn R J, Vashisht A, Smith J R, Healy J C
Department of Radiology, Chelsea and Westminster Hospital, London, England.
Radiology. 2000 Mar;214(3):729-34. doi: 10.1148/radiology.214.3.r00fe07729.
To evaluate the magnetic resonance (MR) imaging appearances of uterine fibroleiomyoma before and after embolization and to determine whether there are preembolization MR imaging characteristics that are predictive of a successful outcome.
MR imaging was performed in 18 patients (32 fibroleiomyomas) before and at 2 and 6 months after embolization of the uterine arteries. On each occasion, fibroleiomyoma signal intensity and gadolinium enhancement characteristics were assessed in comparison with those of myometrium on T1-weighted and gadolinium-enhanced images or with those of skeletal muscle on T2-weighted images. Fibroleiomyoma volume was measured by using the ellipsoid formula.
The mean fibroleiomyoma volume before embolization was 340 cm3 (range, 15-1,383 cm3). The mean reduction in fibroleiomyoma volume was 43% at 2 months and 59% at 6 months. Before embolization, high signal intensity on T1-weighted images was predictive of a poor response (P = .008), and high signal intensity on T2-weighted images was predictive of a good response (P = .007). The degree of gadolinium enhancement was not correlated with fibroleiomyoma volume reduction (P = .46).
MR imaging was useful for evaluation of changes in fibroleiomyoma volume after uterine arterial embolization. MR imaging characteristics of fibroleiomyomas before embolization can help predict subsequent response to treatment.
评估子宫纤维平滑肌瘤栓塞前后的磁共振（MR）成像表现，并确定栓塞前是否存在可预测成功结果的MR成像特征。
对18例患者（32个纤维平滑肌瘤）在子宫动脉栓塞前、栓塞后2个月和6个月进行MR成像。每次成像时，在T1加权像和钆增强像上，将纤维平滑肌瘤的信号强度和钆增强特征与子宫肌层的进行比较，或在T2加权像上与骨骼肌的进行比较。使用椭圆公式测量纤维平滑肌瘤的体积。
栓塞前纤维平滑肌瘤的平均体积为340 cm³（范围为15 - 1383 cm³）。2个月时纤维平滑肌瘤体积平均缩小43%，6个月时缩小59%。栓塞前，T1加权像上的高信号强度提示反应较差（P = 0.008），T2加权像上的高信号强度提示反应良好（P = 0.007）。钆增强程度与纤维平滑肌瘤体积缩小无关（P = 0.46）。
MR成像有助于评估子宫动脉栓塞后纤维平滑肌瘤体积的变化。栓塞前纤维平滑肌瘤的MR成像特征有助于预测后续治疗反应。
