Date of Award

2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Michael Tal

Abstract

The aim of this study was to assess embolic agent equivalency in uterine artery embolization (UAE) using post-procedure MRI enhancement of uterine fibroids in patients embolized using Embosphere Microspheres, (EM) Contour SE spheres (CSE), Poly-Vinyl Alcohol particles (PVA) and Bead Block spheres (BB). A total of 84 women with 6-month MRI follow-up constituted this retrospective study. Within this group, 25 women were treated with PVA, 23 were treated with CSE, 19 were treated with EM and 17 were treated with BB. Pre- and post-procedure MRI exams were analyzed for the total number of fibroids present in the uterus of each patient and the percentage individual fibroid enhancement of each fibroid was scored in quartile intervals. The overall percentage change in enhancement was then calculated for each patient. Bivariate analysis using Generalized Linear Modeling and one-way ANOVA was used to assess differences in infarction by different embolic materials. Of patients treated with PVA and EM, there was a mean reduction in enhancement by 76.60% and 83.07%, respectively, compared to a mean reduction of 52.53% and 49.78% in patients treated with CSE and BB, respectively. There was a statistically significant difference between CSE or BB and EM or PVA. Patients treated with BB and CSE demonstrate a reduced degree of infarction on follow-up MRI than those patients treated with PVA or EM.

Comments

This is an Open Access Thesis.

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