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Published online before print November 12, 2001, 10.1148/radiol.2221010661
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(Radiology 2002;222:45-52.)
© RSNA, 2001


Vascular and Interventional Radiology

Leiomyomata Treated with Uterine Artery Embolization: Factors Associated with Successful Symptom and Imaging Outcome1

James B. Spies, MD, Antoinette R. Roth, BS, Reena C. Jha, MD, Jackeline Gomez-Jorge, MD, Elliot B. Levy, MD, Thomas C. Chang, MD and Susan A. Ascher, MD

1 From the Department of Radiology, Georgetown University Hospital, 3800 Reservoir Rd NW, GC201, Washington, DC 20007-2197. Received March 23, 2001; revision requested April 30; revision received June 8; accepted July 5. Supported in part by research grants from Siemens Medical Systems and the Edward Bennett Williams Interventional Radiology Research and Education Fund. Address correspondence to J.B.S. (e-mail: spiesj@gunet.georgetown.edu).

PURPOSE: To determine whether baseline variables are associated with treatment success after uterine artery embolization for treatment of uterine leiomyoma.

MATERIALS AND METHODS: Two hundred consecutive patients who underwent uterine artery embolization at one institution were prospectively examined. Baseline clinical variables measured included age, race, prior oral contraceptive use or progesterone treatment, prior gonadotropin-releasing hormone agonist treatment, and prior births. Imaging parameters were baseline uterine volume, baseline leiomyoma volume and location, and number of leiomyomas. After treatment, follow-up imaging and questionnaire data were obtained at 3 and 12 months. Associations between baseline characteristics and outcome variables of interest were assessed by using linear regression, logistic regression, Pearson product moment correlation coefficients, and Kendal {tau} correlation coefficients, with adjustment for confounding variables when indicated.

RESULTS: Regression models indicated that larger dominant leiomyoma volume was associated with a smaller percentage reduction in volume at 3 months (P = .03). A submucosal leiomyoma location was associated with a greater volume reduction at 3 months (P = .04), but this difference did not persist at 12 months (P = .09). The odds of reported menstrual bleeding improvement at 3 months were higher with a submucosal leiomyoma location (P = .04); however, this association was not statistically significant after adjustment (P = .07). The odds of improved bulk-related symptoms were not associated with leiomyoma volume change or location.

CONCLUSION: Smaller baseline leiomyoma size and submucosal location are more likely to result in a positive imaging outcome. There are limited associations between other baseline parameters and either symptom change or imaging outcome.

Index terms: Arteries, therapeutic embolization, 854.1264, 98.1264 • Leiomyoma, 854.315, 854.318 • Uterine neoplasms, 854.315 • Uterine neoplasms, MR, 854.1214 • Uterine neoplasms, US, 854.1298




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