Date of Award

2006

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Michael Tal

Abstract

Purpose: To compare the recurrence rate of symptoms and MRI enhancement of uterine fibroids in patients treated with uterine artery embolization (UAE) among three embolic agents: polyvinyl alcohol (PVA) particles, spherical polyvinyl alcohol (SPVA) particles and tris-acryl gelatin microspheres (GM). Materials & Methods: Women treated with UAE for fibroids with PVA, SPVA or GM were contacted by telephone/ mail to complete a modified Uterine Fibroid Symptom Quality of Life (UFS-QOL) survey. Baseline and post-UAE gadolinium-enhanced magnetic resonance imaging (MRI) studies were evaluated for residual or persistent enhancement of any uterine fibroids after UAE. Data was analyzed using 2-tail fishers exact test to correlate symptoms and enhancement and determine the liklihood of recurrence of enhancement and symptoms following UAE among three embolic agents. Results: A total of 101 women underwent UAE with one of the three embolic agents and had complete pre- and post-embolization MRI follow-up. In this group, a total of 24 of 59 (41%) women in the PVA group, 18 of 24 (75%) women in the SPVA group, and 4 of 18 (22%) women in the GM group showed residual enhancement in some or all fibroids. Statistically significant differences in recurrence of residual enhancement on follow-up MR imaging were found between SPVA and PVA (p=0.0072), as well as SPVA and GM (p=0.0015), but not between PVA and GM (p=0.1756). No statistically significant correlation between residual enhancement and symptom recurrence was found based on the survey responses. Conclusion: Patients embolized with SPVA have a higher risk of having residual enhancement on follow-up MR imaging than those embolized with PVA or GM

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