مقاله سال ۲۰۱۶

Uterine artery embolization (UAE) was introduced in 1995 as a treatment option for symptomatic leiomyomas [1]. Over the past two decades, arterial embolization has had a marked impact on the treatment of leiomyomas, and it is now a first-line treatment option for symptomatic leiomyomas [2]. Compared with hysterectomy, UAE is minimally invasive, can be performed with conscious sedation, allows a shorter recovery period, and is thus cost-effective [3-5].

Preprocedure MRI is important for treatment planning and has been shown to alter diagnoses and treatment plans in approximately 20% of women initially thought to have uterine leiomyomas [6]. MRI is used to evaluate leiomyoma burden and can assess the locations, morphology, sizes, and vascularity of uterine leiomyomas. In addition, potential contraindications to UAE are often recognized, including severe adenomyosis, large pedunculated subserosal or submucosal leiomyomas, and vascular anomalies.

Over the past decade, there has been growing interest in expanding the role of interventional radiology (IR) in the evaluation and treatment of patients with uterine leiomyomas. Most previous reports have focused on assessing the impact of direct marketing on procedure volumes and generated revenue without comparing this population with a physician-referred population [7-9]. One prior investigation compared a self-referred population with a gynecologist-referred cohort [10]. In this study, the reported percentage of candidates not suitable for UAE was higher and the percentage of patients actually undergoing UAE was lower in the selfreferred population, although the statistical significance of this difference was not assessed.