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Role of Uterine Artery Doppler Flow in Fibroid Embolization

Departments of Obstetrics and Gynecology (B.M.) and Radiology (R.P., S.G.), University of California, Los Angeles School of Medicine, and Tower-Century Imaging, Century City Hospital (L.A.), Los Angeles, California; and Parkview Imaging, Santa Monica, California (J.D.)

Address correspondence and reprint requests to Bruce McLucas, MD, 100 UCLA Medical Plaza, Suite 310, Los Angeles, CA 90095.

Objective. To determine whether Doppler flow measurements are useful in predicting variables associated with uterine fibroid embolization, including shrinkage of the uterus and myomas, adenomyosis, and uterine fibroid embolization failure. Methods. A group of 227 patients with menorrhagia or postmenopausal bleeding secondary to uterine myomas were evaluated with uterine artery Doppler flow sonography before uterine fibroid embolization. Doppler flow measurements were repeated 6 months after uterine fibroid embolization for 188 of the patients. Data were analyzed for correlations between peak systolic velocity and uterine fibroid embolization patient data, including size and shrinkage of the uterus and myomas, embolization particle size, adenomyosis, and uterine fibroid embolization failure. Results. Initial peak systolic velocity was positively correlated with the size and shrinkage of myomas and uterine volume. Peak systolic velocity was positively correlated with the size and load of embolization particles and was significantly lower (mean, 33.2 cm/s) in patients with adenomyosis than those without adenomyosis (mean, 39.3 cm/s). High peak systolic velocity (>64 cm/s) was a significant predictor of failure. Postembolization peak systolic velocity (mean, 21.85 cm/s) was significantly lower than preembolization peak systolic velocity (mean, 40.33 cm/s) and was not correlated with uterine fibroid embolization variables. Conclusions. Doppler flow measurements can aid in predicting adenomyosis and uterine fibroid embolization failure. Postembolization peak systolic velocity did not show value.

Key Words: Doppler sonography • embolization • myoma • menorrhagia • polyvinyl alcohol • peak systolic velocity • adenomyosis

Abbreviations: PSV, peak systolic velocity • PVA, polyvinyl alcohol • TUV, total uterine volume • UFE, uterine fibroid embolization

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