Presentation
2 months post embolization of large uterine fibroid. Assessment for residual viable tissue
Patient Data
Large right uterine mass with crenated margins showing low signal on T1 and T2 and no enhancement post gadolinium injection. Note Mirena IUCD in situ displaced towards the left and post-operative susceptibility artefact at the LUSCS scar anteriorly (these are not metallic coils used for embolization)
Case Discussion
Polyvinyl alcohol (PVA) particles are used to embolize blood supply to the fibroid via superselective arterial catheterization. The aim of the procedure is to cause bland or dry infarction without liquefaction or necrosis if possible causing the fibroid to shrivel or at least not grow without impeding the possibility of ongoing pregnancy (as compared with surgical myomectomy that "weakens" the uterine wall). The lack of enhancement on MRI shows that the technique in this case has been successful without central liquefaction to indicate necrosis.
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