Objective: To evaluate intratumoral vascularity in symptomatic fibroids after uterine artery embolization (UAE) in the prediction of long-term clinical outcome.
Methods: Thirty-nine patients with symptomatic fibroids were recruited for UAE treatment. Each patient was assessed by color Doppler sonography to look for intratumoral vascularity of the largest hypervascular fibroid the day before UAE and rescanned the lesion 3 days, 3 months and 9 months after UAE. The vascularity of the studied fibroid was classified as absent, peripheral, central and both peripheral and central. Each patient was also monitored clinically after UAE for symptom changes regarding menorrhagia, dysmenorrhea and pressure symptoms at 3-month intervals for a period of three years. The sonographic findings of the studied fibroids in the 9-month scans were compared to the patients’ long-term clinical outcome.
Results: Thirty-three patients were assessed sonographically and clinically in the study. Three patients defaulted follow-up appointments. Another three patients ceased to be monitored clinically because of menopause in one and hysterectomy in two. Of the 33 patients, intratumoral vascularity was found in the studied fibroids of 14 patients in the 9-month scans in which 11 patients (78.6%) had no improvement symptomatically after UAE or symptoms recurred subsequently whereas another three improved clinically in the presence of revascularized fibroids (21.4%). In the remaining 19 patients with no revascularization detected in the studied fibroids, all except two improved clinically (89.5%).
Conclusions: Evaluation of post-UAE intratumoral vascularity of symptomatic fibroids by color Doppler sonography is useful in predicting long-term clinical outcome of the patients.