Avaliação da contratilidade uterina por ressonância magnética em mulheres submetidas a embolização de miomas uterinos

• Ano de defesa: 2018
• Autor(a) principal: Fornazari, Vinicius Adami Vayego [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Uterine fibroid; Therapeutic embolization; Cine-MRi; Uterine peristalsis; Infertility; Mioma; Embolização terapêutica; RM dinâmica; Peristalse uterina; Infertilidade; Transporte de esperma
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7542884; https://repositorio.unifesp.br/handle/11600/52147

Purpose: To evaluate the impact of uterine fibroid embolization (UFE) on uterine contractility using ultrafast magnetic resonance (cineMR) sequences. Method: This prospective study included 26 patients, aged between 30 and 41 years (mean age: 36 years), with symptomatic uterine fibroids undergoing UFE. Patients underwent cineRM sequences before and 6 months after EMUT. Contractility was classified as absent, ordered or disordered. Patients were divided into three patterns of evolution of contractility after UFE: unchanged (group A), favorable modification (group B) and loss of contractility (group C). The following variables were also evaluated: uterine volume, dominant localization of fibroids, fibroidmyometrial index (predominance of myometrium versus predominance of fibroids) and pattern of necrosis of the dominant myometrial nodule after the procedure. Results: Of the 26 patients, eight (30.7%) had no contractility before the procedure, 18 (69.2%) presented with some type of contractility, 11 (61%) were classified as ordered and seven (39%) as disordered. After UFE, the eight patients without contractility presented with contractions, five ordered and three disordered. Of the 11 patients who initially showed ordered contractility, nine remained ordered and two showed loss of contractility. Of the seven patients who initially presented with disordered contractility, one remained disordered, five began to have ordered contractions and one showed loss of contractility. Regarding the evolution of the contractility pattern, 10 (38%) patients had no change in the pattern (group A), 13 (50%) had a positive change in contractility (group B) and three had loss of contractility (group C). Uterine volume, dominant location of fibroids, fibroidmyometrial index and pattern of myometrial nodule necrosis were not statistically significant when comparing the evolution pattern groups. Conclusion: UFE may be related to an improvement in uterine contractility pattern. Uterine volume, fibroid location, fibroidmyometrial index and pattern of fibroid necrosis do not seem to be related to the evolution of the uterine contractility pattern.