Preprocedural MRI and MRA in planning fibroid embolization

Area of Science:

• Radiology
• Interventional Radiology
• Gynecologic Imaging

Background:

• Uterine artery embolization (UAE) is a common treatment for uterine fibroids.
• Accurate preprocedural imaging is crucial for successful UAE planning and patient selection.
• Magnetic resonance imaging (MRI) offers detailed anatomical and tissue characterization relevant to UAE.

Purpose of the Study:

• To review the current applications of preprocedural MRI and MRA in planning UAE for fibroid treatment.
• To highlight the role of MRA in visualizing pelvic vasculature and guiding UAE procedures.
• To present MRI features of fibroids and their differentials, impacting treatment outcomes.

Main Methods:

• Review of current literature on MRI/MRA in UAE.
• Illustration of pelvic arterial anatomy and vascular variants relevant to UAE.
• Correlation of conventional angiography with MRA findings.
• Presentation of fibroid characteristics influencing patient selection and outcomes.

Main Results:

• MRI/MRA effectively demonstrates pelvic vasculature for UAE guidance.
• Fibroid characteristics (location, size, enhancement) on MRI impact treatment selection and outcomes.
• MRA facilitates straightforward determination of optimal uterine artery catheterization angles.
• MRA aids in minimizing ionizing radiation exposure during UAE procedures.

Conclusions:

• Preprocedural MRI/MRA is valuable for patient selection and procedural planning in UAE.
• MRA enhances visualization of pelvic vasculature, improving UAE guidance and safety.
• Standardized MRI/MRA reporting can optimize preassessment for UAE in fibroid management.