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.
| Identifer | oai:union.ndltd.org:YALE_med/oai:ymtdl.med.yale.edu:etd-06282006-134426 |
| Date | 15 November 2006 |
| Creators | Patel, Trusher |
| Contributors | Michael Tal |
| Publisher | Yale University |
| Source Sets | Yale Medical student MD Thesis |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://ymtdl.med.yale.edu/theses/available/etd-06282006-134426/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Yale School of Medicine or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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