Role of uterine artery Doppler in the management of uterine leiomyoma by arterial embolization

Abstract

Objectives To study Doppler changes in the uterine artery immediately following and 3 months after uterine artery embolization (UAE)

Influence of ulipristal acetate therapy compared with uterine artery embolization on fibroid volume and vascularity indices assessed by three-dimensional ultrasound: prospective observational study

“…Showing that fibroid vascularization decreases after UPA therapy is not only an interesting scientific observation but also provides a theoretical rationale for future studies that could investigate the possible relationship between initial fibroid vascularization and outcome of UPA treatment. Moreover, evaluating changes in uterine artery blood flow enables the prediction of fibroid volume reduction after UAE, therefore perhaps it will be possible to predict the long‐term effects of UPA by assessing the changes in vascular indices following treatment. Finally, we present a new approach to 3D power Doppler indices.…”

“…Interestingly, it has been suggested that the amount of reduction in fibroid volume during the first year following UAE may predict long‐term outcome. Similarly, initial fibroid vascularization or changes in uterine artery blood flow after UAE may predict the decrease in fibroid volume after the procedure. UPA therapy decreases fibroid volume, but its impact on vascularity has not yet been investigated.…”

Uterine fibroid vascularization: from morphological evidence to clinical implications

“…The reduction in fibroid vascularity after UAE seems to precede the decrease of fibroid volume at three months; indeed, fibroids without detectable vascularization are those with the most significant volume reduction (Tranquart et al, 2002). The RI of uterine arteries may predict volume reduction at three months after UAE since it is reported that a RI value between 0.82 and 0.88 immediately after the procedure is associated with a 38-61% reduction in fibroid volume at three months (Naguib et al, 2012). In addition, 3D Power Doppler fibroid vascularization parameters seem to reduce after three months from UAE (VI 1.44 vs. 0.12, FI 24.01 vs. 10.44, and VFI 0.24 vs. 0.01) (Czuczwar et al, 2015).…”

Uterine Artery Embolization and New Ablation Techniques

“…Directly after the procedure the following factors were of predictive value: when less than 90 % of the fi broids showed signs of infarction on the post-UAE MRI scan there was more chance of re-interventions [ 15 , 16 ]. Post-UAE fi broid volume at follow up was related to post-UAE dopplers (resistance index) directly after the procedure [ 17 ].…”