PURPOSE: To determine the effect of partial versus complete leiomyoma infarction on relief of leiomyoma-related symptoms and freedom from invasive reinterventions and to assess if patient age, location of the dominant leiomyoma, number of leiomyomas, or baseline uterine and dominant leiomyoma volume were associated with clinical failure. MATERIALS AND METHODS: Study protocol was approved by the institutional review board, and informed consent was obtained. One hundred fifteen consecutive women (median age, 42 years; range, 34-61 years) with symptomatic uterine leiomyomas underwent contrast material-enhanced magnetic resonance (MR) imaging at baseline and 24-72 hours after uterine artery embolization (UAE) to determine the percentage of infarction of leiomyoma tissue (complete = 100%, almost complete = 90%-99%, and partial = 0%-89%). Clinical outcome and frequency of reinterventions were compared for up to 36 months. RESULTS: One hundred thirteen patients completed at least one clinical follow-up. Twenty-four months after UAE, 50% +/- 15.2 (standard error) of the patients with partial infarction and 80% +/- 13.4 (standard error) of patients with almost complete infarction had undergone no reintervention. No patient with complete infarction needed a second treatment (P < .001). The hazard ratios for reintervention between the complete infarction group and the almost complete and partial infarction groups were 15.88 (95% confidence interval [CI]: 1.22, 2225.54; P = .034) and 73.08 (95% CI: 8.33, 9636.35; P < .001), respectively. There were significant differences in hazard ratios between patients with partial and those with complete infarction for persistence or recurrence of menorrhagia (hazard ratio, 7.45; 95% CI: 2.08, 28.31; P = .002) and bulk-related symptoms (hazard ratio, 5.90; 95% CI: 1.66, 21.92; P = .007). There was no significant correlation between patient age, number of leiomyomas, location of the dominant leiomyoma, or baseline uterine and dominant leiomyoma volume and clinical failure. CONCLUSION: Women with leiomyoma infarction above 90% on contrast-enhanced MR images after UAE show significantly better symptom control and fewer reinterventions than do patients with a lower infarction rate.
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机译：目的：确定部分或完全性平滑肌瘤梗塞对减轻平滑肌瘤相关症状和免于侵入性再干预的影响，并评估患者年龄，优势平滑肌瘤位置，平滑肌瘤数量或基线子宫和优势平滑肌瘤数量是否相关临床失败。材料与方法：研究方案经机构审查委员会批准，并获得知情同意。连续115例有症状子宫平滑肌瘤的女性（中位年龄42岁;范围34-61岁）在基线和子宫动脉栓塞后（UAE）后24-72小时接受造影剂增强磁共振（MR）成像以确定平滑肌瘤组织梗塞的百分比（完全= 100％，几乎完全= 90％-99％，部分= 0％-89％）。比较了长达36个月的临床结果和再次干预的频率。结果：113例患者至少完成了一项临床随访。在阿拉伯联合酋长国后的24个月，部分梗死患者的50％+/- 15.2（标准误）和几乎完全梗死的患者80％+ /-13.4（标准误）没有接受再次干预。没有完全梗死的患者不需要再次治疗（P <.001）。完全梗死组与几乎完全和部分梗死组之间再次干预的危险比分别为15.88（95％置信区间[CI]：1.22，2225.54; P = .034）和73.08（95％CI：8.33，9636.35; P <.001）。部分或完全梗死的月经过多或复发的患者的危险比（危险比，7.45; 95％CI：2.08，28.31; P = .002）和大量相关症状（危险比， 5.90; 95％CI：1.66，21.92; P = .007）。患者年龄，平滑肌瘤数目，优势平滑肌瘤的位置或基线子宫和优势平滑肌瘤的数量与临床失败之间无显着相关性。结论：与梗死发生率较低的患者相比，UAE造影剂增强后的MR图像显示肌瘤梗死的女性超过90％表现出更好的症状控制和更少的再干预。
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