Combination of microspheres and gadoteridol for the determination of non-target ovarian embolization during uterine artery embolization. A case series
- Authors: Sharafutdinov B.M.1,2, Ryzhkin S.A.1,3,4,5, Galim'yanov D.A.1, Gaziev E.A.1
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Affiliations:
- Kazan Federal University
- Kazan State Medical Academy – branch of the Russian Medical Academy of Continuous Professional Education
- Russian Medical Academy of Continuous Professional Education
- Kazan State Medical University
- Federal Center for Toxicological, Radiation and Biological Safety
- Issue: Vol 24, No 4 (2022)
- Pages: 458-463
- Section: CLINICAL ONCOLOGY
- URL: https://journals.rcsi.science/1815-1434/article/view/132979
- DOI: https://doi.org/10.26442/18151434.2022.4.201896
- ID: 132979
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Abstract
Background. Uterine myoma is the most common benign tumor of the pelvic organs in women. One of the effective therapies for myomas is uterine artery embolization (UAE), which can be associated with unintended ovarian embolization. However, there is no certainty about the effect of unintended ovarian embolization on fertility and ovarian function since no precise evidence-based ways of identifying unintended embolization have been described.
Aim. To develop a highly accurate method for identifying unintended ovarian embolization during UAE.
Materials and methods. A series of clinical cases of the utilization of combined embolization material based on the paramagnetic contrast agent gadoteridol and saturable HepaSphere microspheres are presented.
Results. On admission, patients underwent magnetic resonance imaging (MRI) of the pelvic organs with contrast enhancement. After UAE with this combined embolization material, another pelvic MRI without contrast enhancement was performed on the in-hospital day 2. In the first clinical case, no hyperintensive zones were detected in the ovarian stroma. However, in the second case, a previously undetected hyperintensive signal up to 6 mm in diameter was seen in the stroma of the left ovary by repeat MRI.
Conclusion. Using this combined material during UAE significantly increases the accuracy of possible unintended ovarian embolization detection as soon as in the early postoperative period.
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##article.viewOnOriginalSite##About the authors
Bulat M. Sharafutdinov
Kazan Federal University; Kazan State Medical Academy – branch of the Russian Medical Academy of Continuous Professional Education
Author for correspondence.
Email: bulaty555@mail.ru
ORCID iD: 0000-0002-4149-118X
SPIN-code: 6282-4554
Cand. Sci. (Med.)
Russian Federation, Kazan; KazanSergey A. Ryzhkin
Kazan Federal University; Russian Medical Academy of Continuous Professional Education; Kazan State Medical University; Federal Center for Toxicological, Radiation and Biological Safety
Email: rsa777@inbox.ru
ORCID iD: 0000-0003-2595-353X
SPIN-code: 5955-5712
D. Sci. (Med.), Assoc. Prof.
Russian Federation, Kazan; Moscow; Kazan; KazanDiaz A. Galim'yanov
Kazan Federal University
Email: Da.Galimyanov@mail.ru
ORCID iD: 0000-0001-7725-7697
SPIN-code: 7021-5543
Department Head
Russian Federation, KazanEdgar A. Gaziev
Kazan Federal University
Email: gazievedgar@gmail.com
ORCID iD: 0000-0001-8692-1967
SPIN-code: 7135-6593
Doctor
Russian Federation, KazanReferences
- Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372(17):1646-55. doi: 10.1056/NEJMcp1411029
- Pelage JP, Cazejust J, Pluot E, et al. Uterine fibroid vascularization and clinical relevance to uterine fibroid embolization. Radiographics. 2005;25 (Suppl. 1):S99-117. doi: 10.1148/rg.25si055510
- Razavi MK, Wolanske KA, Hwang GL, et al. Angiographic classification of ovarian artery-to-uterine artery anastomoses: initial observations in uterine fibroid embolization. Radiology. 2002;224(3):707-12. doi: 10.1148/radiol.2243011513
- Lanciego C, Diaz-Plaza I, Ciampi JJ, et al. Utero-ovarian anastomoses and their influence on uterine fibroid embolization. J Vasc Interv Radiol. 2012;23(5):595-601. doi: 10.1016/j.jvir.2012.01.077
- Kaump GR, Spies JB. The impact of uterine artery embolization on ovarian function. J Vasc Interv Radiol. 2013;24(4):459-67. doi: 10.1016/j.jvir.2012.12.002
- de Bruijn AM, Ankum WM, Reekers JA, et al. Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10-year outcomes from the randomized EMMY trial. Am J Obstet Gynecol. 2016;215(6):745.e1-12. doi: 10.1016/j.ajog.2016.06.051
- Karlsen K, Hrobjartsson A, Korsholm M, et al. Fertility after uterine artery embolization of fibroids: a systematic review. Arch Gynecol Obstet. 2018;297(1):13-25. doi: 10.1007/s00404-017-4566-7
- Kim HS, Tsai J, Lee JM, et al. Effects of utero-ovarian anastomoses on basal follicle-stimulating hormone level change after uterine artery embolization with tris-acryl gelatin microspheres. J Vasc Interv Radiol. 2006;17(6):965-71. doi: 10.1097/01.RVI.0000220425.23309.15
- Manyonda I, Belli AM, Lumsden MA, et al. Uterine-Artery Embolization or Myomectomy for Uterine Fibroids. N Engl J Med. 2020;383(5):440-51. doi: 10.1056/NEJMoa1914735
- Ishisaki JY, Kato H, Zhang X, et al. Comparison of 1.5 T and 3 T non-contrast-enhanced MR angiography for visualization of uterine and ovarian arteries before uterine artery embolization. Eur Radiol. 2022;32(1):470-76. doi: 10.1007/s00330-021-08141-z