Uterine Leiomyoma Embolization: Role of Power Doppler Ultrasonography

Abstract

PURPOSE: The vascularity of uterine leiomyoma was evaluated by power Doppler ultrasonography (PDUS) before and after bilateral uterine artery embolization (UAE) in order to establish the efficacy of the procedure and contribution to the treatment. MATERIALS AND METHODS: UAE was performed in 20 symptomatic patients with uterine leiomyoma. In addition to MRI and gray scale US, patients were evaluated by PDUS to assess the vascularity of the uterus and leiomyomas before and 6 months after the embolization and the findings were compared with angiography. Vascularity was categorized into 3 groups as mild (5 cases), moderate (7 cases) and marked (8 cases). Relationship between the findings of PDUS and treatment results were analyzed statistically by one-way ANOVA and post-hoc Tukey tests. RESULTS: In PDUS except their calcified and degenerated regions leiomyomas displayed more vascularity peripherally than centrally, before the embolization. Six months after the embolization, a decrease of 37%, 44% and 59% was observed in the mass of the leiomyomas that had revealed mild, moderate and marked vascularity before the embolization. Greater mass reduction occurred in leiomyomas with high pre-embolization vascularity (p < 0.05). CONCLUSION: PDUS gives important information about the vascularity of uterine leiomyomas before and after uterine artery embolization, which became a widespread treatment option in recent years. It can be helpful in the selection of patients for uterine artery embolization by revealing the vascularity of the leiomyomas. Also it is a non-invasive and cheap method in the determination of the efficacy of the procedure in the early and late periods after embolization.