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Uterine Artery Embolization for Adenomyosis: Percentage of Necrosis Predicts Midterm Clinical Recurrence

 Sohi H.Bae  ;  Man Deuk Kim  ;  Gyoung Min Kim  ;  Shin Jae Lee  ;  Sung Il Park  ;  Jong Yun Won  ;  Do Yun Lee 
 Journal of Vascular and Interventional Radiology, Vol.26(9) : 1290-1296, 2015 
Journal Title
 Journal of Vascular and Interventional Radiology 
Issue Date
Adenomyosis/diagnosis ; Adenomyosis/epidemiology* ; Adenomyosis/therapy* ; Adult ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Menorrhagia/diagnosis ; Menorrhagia/epidemiology* ; Middle Aged ; Necrosis ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology* ; Prevalence ; Recurrence ; Republic of Korea/epidemiology ; Petrospective Studies ; Risk Factors ; Symptom Assessment ; Treatment Outcome ; Uterine Artery Embolization/statistics & numerical data* ; Uterus/pathology*
PURPOSE: To evaluate the effect of degree of necrosis after uterine artery embolization (UAE) on symptom recurrence at midterm clinical follow-up in patients with adenomyosis. MATERIALS AND METHODS: Women (N = 50) who underwent UAE for symptomatic adenomyosis were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance (MR) imaging at baseline and 3 months after UAE and were followed clinically for at least 18 months. The type of adenomyosis was classified as focal or diffuse. The uterine volume and the percentage of necrosis after embolization were measured three-dimensionally on MR imaging. The percentage of the necrosis cutoff point for predicting recurrence was estimated. Patients were divided into 2 groups according to the cutoff point. The rate of recurrence was compared between groups, and risk factors for recurrence were identified. RESULTS: During the follow-up period (range, 18-48 mo), symptom recurrence occurred in 12 of 50 patients. A necrosis cutoff point of 34.3% was calculated to predict recurrence (area under the curve = 0.721; 95% confidence interval [CI] = 0.577-0.839; P = .004). Patients with < 34.3% necrosis (group A, n = 12) were at a significantly higher risk of recurrence than patients with > 34.3% necrosis (group B, n = 38; hazard ratio = 7.0; 95% CI = 2.2, 22.4; P = .001). Initial uterine volume and type of adenomyosis were not associated with recurrence. CONCLUSIONS: The percentage of necrosis in patients with adenomyosis after UAE may predict symptom recurrence at midterm follow-up. The cutoff percentage of necrosis required to predict symptom recurrence was 34.3% in this study.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Bae, Sohi(배소희)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Lee, Shin Jae(이신재)
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