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16.02.2017 | Interventional

Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids

verfasst von: Young-sun Kim, Tae-Joong Kim, Hyo Keun Lim, Hyunchul Rhim, Sin-Ho Jung, Joong Hyun Ahn, Jeong-Won Lee, Byoung-Gie Kim

Erschienen in: European Radiology | Ausgabe 9/2017

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Abstract

Objective

To evaluate the integrity of endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) ablation of submucosal uterine fibroids based on contrast-enhanced MRI findings, and to identify the risk factors for endometrial impairment.

Methods

In total, 117 submucosal fibroids (diameter: 5.9 ± 3.0 cm) in 101 women (age: 43.6 ± 4.4 years) treated with MR-HIFU ablation were retrospectively analysed. Endometrial integrity was assessed with contrast-enhanced T1-weighted images at immediate (n = 101), 3-month (n = 62) and 12-month (n = 15) follow-ups. Endometrial impairment was classified into grades 0 (continuous endometrium), 1 (pin-point, full-thickness discontinuity), 2 (between grade 1 and 3), or 3 (full-thickness discontinuity >1 cm). Risk factors were assessed with generalized estimating equation (GEE) analysis.

Results

Among 117 fibroids, grades 0, 1, 2 and 3 endometrial impairments were observed at initial examination in 56.4%, 24.8%, 13.7% and 4.3%, respectively. Among 37 fibroid cases of endometrial impairment for which follow-ups were conducted, 30 showed improvements at 3- and/or 12-month follow-up. GEE analysis revealed the degree of endometrial protrusion was significantly associated with severity of endometrial injury (P < 0.0001).

Conclusions

After MR-HIFU ablation of submucosal fibroids, endometrial enhancement was preserved intact or minimally impaired in most cases. Impaired endometrium, which is more common after treating endometrially-protruded fibroids, may recover spontaneously.

Key Points

• After MR-HIFU ablation for submucosal fibroid, endometrium is mostly preserved/minimally impaired.

• Endometrial-protruded submucosal fibroid is susceptible to more severe endometrial impairment.

• The impaired endometrium may recover spontaneously at follow-up MR exams.

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Titel: Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids
verfasst von: Young-sun Kim
Tae-Joong Kim
Hyo Keun Lim
Hyunchul Rhim
Sin-Ho Jung
Joong Hyun Ahn
Jeong-Won Lee
Byoung-Gie Kim
Publikationsdatum: 16.02.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4765-4

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Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids