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

Publication ,  Journal Article
Kim, Y-S; Kim, T-J; Lim, HK; Rhim, H; Jung, S-H; Ahn, JH; Lee, J-W; Kim, B-G
Published in: Eur Radiol
September 2017

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.

Duke Scholars

Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

September 2017

Volume

27

Issue

9

Start / End Page

3956 / 3965

Location

Germany

Related Subject Headings

  • Uterine Neoplasms
  • Treatment Outcome
  • Surgery, Computer-Assisted
  • Retrospective Studies
  • Organ Sparing Treatments
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Magnetic Resonance Imaging, Interventional
  • Magnetic Resonance Imaging
  • Leiomyoma
 

Citation

APA
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ICMJE
MLA
NLM
Kim, Y.-S., Kim, T.-J., Lim, H. K., Rhim, H., Jung, S.-H., Ahn, J. H., … Kim, B.-G. (2017). Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids. Eur Radiol, 27(9), 3956–3965. https://doi.org/10.1007/s00330-017-4765-4
Kim, Young-Sun, Tae-Joong Kim, Hyo Keun Lim, Hyunchul Rhim, Sin-Ho Jung, Joong Hyun Ahn, Jeong-Won Lee, and Byoung-Gie Kim. “Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids.Eur Radiol 27, no. 9 (September 2017): 3956–65. https://doi.org/10.1007/s00330-017-4765-4.
Kim, Young-Sun, et al. “Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids.Eur Radiol, vol. 27, no. 9, Sept. 2017, pp. 3956–65. Pubmed, doi:10.1007/s00330-017-4765-4.
Kim Y-S, Kim T-J, Lim HK, Rhim H, Jung S-H, Ahn JH, Lee J-W, Kim B-G. Preservation of the endometrial enhancement after magnetic resonance imaging-guided high-intensity focused ultrasound ablation of submucosal uterine fibroids. Eur Radiol. 2017 Sep;27(9):3956–3965.

Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

September 2017

Volume

27

Issue

9

Start / End Page

3956 / 3965

Location

Germany

Related Subject Headings

  • Uterine Neoplasms
  • Treatment Outcome
  • Surgery, Computer-Assisted
  • Retrospective Studies
  • Organ Sparing Treatments
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Magnetic Resonance Imaging, Interventional
  • Magnetic Resonance Imaging
  • Leiomyoma