Sutter Olivier, Soyer Philippe, Shotar Eimad, Dautry Raphael, Guerrache Youcef, Placé Vinciane, Opréa Raluca, Ricbourg Aude, Le Dref Olivier, Boudiaf Mourad, Sirol Marc, Dohan Anthony
Department of Body and Interventional Imaging, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France.
Université Paris-Diderot, Sorbonne Paris Cité, 10 rue de Verdun, 75010, Paris, France.
Eur Radiol. 2016 Oct;26(10):3558-70. doi: 10.1007/s00330-016-4210-0. Epub 2016 Jan 22.
To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI).
Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE.
By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 × 10(-3) mm(2)/s vs. 0.712 × 10(-3) mm(2)/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization.
Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect.
• A drop in leiomyoma ADC values is observed 6 months after UAE. • Drop in leiomyoma ADC value is associated with leiomyoma devascularizarion after UAE. • MR 48 h post-UAE allows assessing leiomyoma devascularization. • Myometrium perfusion defect occurs more often in women with a smaller uterus.
检测子宫动脉栓塞术（UAE）后子宫平滑肌瘤表观扩散系数（ADC）值的变化是否与预后相关，并通过磁共振成像（MRI）评估UAE对平滑肌瘤和正常子宫肌层的影响。
回顾性分析49例接受UAE前后盆腔MRI检查的女性患者的数据。计算UAE前后子宫和平滑肌瘤体积、平滑肌瘤ADC值以及正常子宫肌层的ADC值。
与基线ADC值相比，UAE术后6个月平滑肌瘤ADC值显著下降（分别为1.096×10⁻³mm²/s和0.712×10⁻³mm²/s；p＜0.0001），但术后48小时未出现下降。48小时时，40/49例女性（82%）平滑肌瘤去血管化完全，6个月时为37/49例女性（76%）。6个月时平滑肌瘤体积缩小及ADC值与去血管化程度相关。UAE术后子宫肌层ADC值显著下降。48小时时，14/49例女性（28.5%）观察到子宫肌层灌注缺损，且与较高程度的平滑肌瘤去血管化相关。
UAE术后6个月，平滑肌瘤ADC值下降及体积缩小与平滑肌瘤去血管化程度相关。UAE影响子宫肌层，表现为ADC值下降及最初的子宫肌层灌注缺损。
• UAE术后6个月观察到平滑肌瘤ADC值下降。• UAE术后平滑肌瘤ADC值下降与去血管化相关。• UAE术后48小时的MRI可评估平滑肌瘤去血管化。• 子宫较小的女性更容易出现子宫肌层灌注缺损。
