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Degeneration of Leiomyoma in Patients Referred for Uterine Fibroid Embolization: Incidence, Imaging Features and Clinical Characteristics

Authors
 Seung Chul Han  ;  Man-Deuk Kim  ;  Dae Chul Jung  ;  Myungsu Lee  ;  Mu Sook Lee  ;  Sung Il Park  ;  Jong Yun Won  ;  Do Yun Lee  ;  Kwang Hun Lee 
Citation
 YONSEI MEDICAL JOURNAL, Vol.54(1) : 215-219, 2013 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2013
MeSH
Abdominal Pain/therapy ; Adult ; Female ; Follow-Up Studies ; Humans ; Incidence ; Leiomyoma/complications* ; Leiomyoma/epidemiology ; Leiomyoma/pathology* ; Leiomyoma/surgery* ; Magnetic Resonance Imaging ; Menorrhagia/therapy ; Middle Aged ; Pregnancy ; Retrospective Studies ; Treatment Outcome ; Uterine Artery Embolization*
Keywords
Uterine artery embolization ; magnetic resonance imaging ; degeneration ; leiomyoma ; uterus
Abstract
PURPOSE:
Imaging features and clinical characteristics of degenerated leiomyoma in patients referred for uterine fibroid embolization (UFE) were analyzed to assess the incidence of degenerated leiomyoma.
MATERIALS AND METHODS:
Patients referred for UFE between 2008 and 2009 were retrospectively analyzed (n=276). Patients ranged in age from 27 to 51 years (mean 38.0 years). All patients underwent screening MRI with contrast enhancement. Medical histories and clinical symptoms were evaluated.
RESULTS:
Among the 276 patients who underwent MRI, 14 (5.1%) showed degenerated leiomyomas. Symptoms were abdominal pain (n=4, 26.7%), menorrhagia (n=5, 35.7%) and bulk-related symptoms (n=5, 35.7%) and no symptoms (n=5, 35.7%). Of the 14 patients with degenerated leiomyomas, 5 (42.9%) had a history of pregnancy in the past two years. For T1-weighted imaging (T1WI), a high signal intensity (SI) of the leiomyoma was the most common finding (n=9, 64.3%) and a hyperintense rim (n=4, 28.6%) was the second most common. On T2-weighted imaging (T2WI), a low SI of the leiomyoma was found in six patients (42.9%), a high SI in four (28.6%) and a heterogeneous SI in four (28.6%) patients. Conservative management was performed in 11 (78.6%) patients, surgery in 3 (21.4%) and uterine artery embolization in one (7.1%) patient.
CONCLUSION:
The incidence of degeneration of leiomyoma in patients referred for UFE was 5.1%. Patients presented with variable clinical symptoms with or without a history of pregnancy. MR imaging showed a high SI on T1WI and various SIs on T2WI without contrast enhancement. An understanding of the degeneration of leiomyomata is essential when considering UFE.
Files in This Item:
T201300242.pdf Download
DOI
10.3349/ymj.2013.54.1.215
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hoon(이광훈)
Lee, Do Yun(이도연)
Lee, Myung Su(이명수)
Lee, Mu Sook(이무숙)
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86280
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