Contrast-enhanced MR angiography of uterine arteries for the prediction of ovarian artery embolization in 349 patients

Abstract

Purpose: To assess contrast-enhanced magnetic resonance (MR) angiographic findings of uterine arteries (UAs) and to evaluate the diagnostic utility of this imaging modality for the prediction of ovarian artery (OA) embolization (OAE).

Materials and methods: The authors retrospectively evaluated 349 patients who underwent contrast-enhanced MR angiography before UA embolization (UAE) for symptomatic fibroid tumors or adenomyosis. The diameters of the UAs were compared with those of the inferior mesenteric arteries (IMAs) and classified into two groups: group I, in which the diameters of both UAs were the same as or greater than that of the IMA; and group II, in which at least one UA was smaller than the IMA or was not visible. The presence of an enlarged OA was also evaluated. Sensitivity and specificity were calculated for UA diameter, enlarged OA, and the combination of the two.

Results: Nine of 22 patients (40.9%) in group II underwent OAE, which was a significantly higher incidence (P < .001) than in group I (nine of 327; 2.8%). Among eight patients with enlarged OAs, six (75%) underwent OAE. Relative UA diameter had a sensitivity of 50% and specificity of 96.1%; the respective values for enlarged OAs were 33.3% and 99.3%. The combination of UA diameter and enlarged OAs showed a sensitivity and specificity of 72.2% and 95.4%, respectively.

Conclusions: In addition to the identification of enlarged OAs, contrast-enhanced MR angiography allows a comparison between UA and IMA diameters and therefore can be helpful for the prediction of OAE.