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Uterine artery embolization for leiomyomas: pre- and postprocedural evaluation with US.
Sangeet Ghai1, Dheeraj K Rajan, Matthew S Benjamin
1Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University Health Network-Mount Sinai Hospital, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, Ontario, Canada M5G 2N2.
Summary
Ultrasonography (US) is crucial for evaluating uterine artery embolization (UAE) success and complications in women with fibroids. Familiarity with post-procedure US findings helps avoid misinterpretation and unnecessary interventions.
Area of Science:
- Radiology
- Gynecology
- Medical Imaging
Background:
- Transabdominal and transvaginal ultrasonography (US) are standard imaging techniques for assessing the uterus and pelvis.
- These modalities are frequently employed before and after uterine artery embolization (UAE) for symptomatic leiomyomas (fibroids).
Purpose of the Study:
- To highlight the role of US in preprocedural assessment and postprocedural evaluation of UAE.
- To emphasize the importance of understanding typical postprocedural US findings to prevent misinterpretation and unnecessary interventions.
- To discuss the utility of US as a first-line imaging modality in UAE patient management.
Main Methods:
- Review of preprocedural and postprocedural US findings in patients undergoing UAE for leiomyomas.
- Comparison of US with other imaging modalities like MRI and CT for specific conditions.
- Emphasis on the radiologist's familiarity with expected US outcomes post-UAE.
Main Results:
- Preprocedural US can identify contraindications for UAE.
- Postprocedural US assesses fibroid involution and detects complications.
- Understanding US findings enables objective determination of treatment response and complication detection.
- While MRI/CT offer high accuracy for specific pathologies, US remains a readily available first-line tool.
Conclusions:
- Ultrasonography is an essential, accessible tool for evaluating patients undergoing UAE for fibroids.
- Accurate interpretation of postprocedural US findings is critical for effective patient management and avoiding interventions.
- US facilitates objective assessment of treatment efficacy and complication identification following UAE.