Date of Award
Open Access Thesis
Medical Doctor (MD)
The purpose of this study is to determine features of uterine leiomyoma on Magnetic Resonance Imaging (MRI) that identify predictors of response to Uterine Arterial Embolization (UAE). MRI images were obtained before and after UAE in 35 women. These images were analyzed for uterine and fibroid size changes along with fibroid border characteristics and location for a total of 73 fibroids. Fibroids were classified as either smooth or lobulated based on border appearance on MR imaging to determine any differences in mean fibroid volume reduction post-embolization. The mean decrease in fibroid volume from pre-embolization to post-embolization was 48.1% ± 28.6 % (SD) (P < 0.001). No statistical difference was detected in the mean volume reduction between lobulated and smooth fibroids, 40.6% ± 23.1% (SD) and 50.9% ± 30.2% (SD) respectively, with a confidence interval [-25.1, 4.6, SEM 7.5, Df 71], single factor ANOVA (F[1,71]=1.88, Fcrit=3.98, p=0.17). However, some difference was detected in the failure rate of lobulated versus smooth fibroids to embolization, 5% and 9.4% respectively, ANOVA (F [1, 71]= 0.37, Fcrit= 3.98, p > 0.1), albeit at low statistical power. Also no difference was detected in mean fibroid volume reduction between intramural, submucosal, and subserosal fibroids. Thus, we introduced a novel characteristic by which to classify uterine fibroids based upon border appearance on MR imaging.
Patel, Trusher, "Uterine Arterial Embolization: Classification of Leiomyomas to Determine Predictors of Response" (2006). Yale Medicine Thesis Digital Library. 278.