Practical Application of a Coronal MR Image during a Uterine Fibroid Embolization (UFE)

To assess the role of coronal MR images during uterine fibroid embolization (UFE). A prospective study of 100 consecutive patients who underwent a uterine fibroid embolization was performed. The average age at embolization was 40.2 years (range, 19-49 years). The size of the predominant fibroids ranged from 2.5 cm to 21.0 cm (mean, 7.5 cm). The embolic agents included non-spherical polyvinyl alcohol particles. The angiographic and spot images after embolization were compared with coronal MR images. The patterns were divided into three categories: Matching, Undetermined, and Mismatching. Coronal MR images were correlated with angiographic or single shot images of the uterus after embolization in 94 cases, undeterminined in three cases, and mismatched in three cases. Post-embolization aortographies were not helpful in patients showing complete matching images. In three cases of mismatching, two had ovarian collateral supplies to predominant fibroids in the uterine fundus and the remaining patient had an internal pudendal artery of collaterals to fibroid. Mismatching spot images combined with MRI allowed us to find other collateral vascularities. Coronal MR images provided comprehensive information for the appropriate UFE. When perfectly matched, we could make sure that a particular UFE is appropriate without concern for collaterals