Assessment of uterine fibroid infarction after embolization with tris-acryl gelatin microspheres

Abstract

Purpose: To evaluate the degree of fibroid infarction after uterine fibroid embolization (UFE) with tris-acryl gelatin microsphere (Embosphere) visualized by contrast-enhanced magnetic resonance imaging (MRI) and evaluation of the clinical outcome measured with symptom and quality of life questionnaire (UFS-QOL) after 3 months follow-up. Materials and Methods: A prospective study included twenty-six pre-menopausal women. UFE with Embosphere of 500–900 μm was performed. Residual contrast enhancement in the total fibroid burden was analyzed and residual contrast enhancement ≤10% was defined as a satisfactory result after embolization. The dominant fibroids and total uterine volumes were assessed by MRI before and at follow-up. The UFS-QOL questionnaire answers were analysed and compared. Results: Twenty-five of 26 patients (96%) had a technically successful UFE. Twenty-four of the patients (92%) had MRI controls 3 months after UFE of which 23 patients had complete or almost complete fibroid burden infarction without residual contrast enhancement of the fibroids of more than 10%. One patient had insufficient fibroid burden infarction. Twenty-three of the patients had UFS-QOL analyses of which 96% had significant clinical improvement. Conclusion: UFE with Embosphere of 500–900 μm gave satisfactory MRI results with residual fibroid contrast enhancement ≤10% and good clinical effect in 96% of patients.

Keywords

• uterine fibroid embolization
• embolization
• minimally invasive procedures