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DOI: 10.1055/s-0033-1346522
Analysis of the Origin of the Uterine Artery in Females using 3D Reconstructed Contrast Enhanced MR Angiography before Uterine Artery Embolization: Where to look for it when you do not find it
Ziele: To describe the different patterns of origin of the uterine artery from the internal iliac artery in females before uterine artery embolization (UAE) using three dimensional (3D) reconstructed contrast enhanced MR angiography (CE-MRA). Methode: The study was retrospectively performed on 84 females with a mean age of 45.5 year. Pre-embolization CE-MRA was performed to all patients before UAE. 3D images were reconstructed using Syngo VesselView application. 3D reconstructions and evaluations were performed by two radiologists in consensus. For each uterine artery the point of origin was identified and the angle which the artery makes with its main stem of origin was calculated. Ergebnis: The uterine artery was detected in 165 (98.2%) of the 168 (in 84 patients) arteries. It originated directly from the anterior division of the internal iliac artery (IIA) in 141 arteries of the detected arteries (85.5%). The origin was from the bifurcation point of the IIA in 7 arteries (4.2%), from the main stem of the IIA in 3 arteries (1.8%) and 1 uterine artery (0.6%) originated from the posterior division of the IIA. It originated indirectly from the anterior division with a common segment with other arteries in 13 arteries (7.9%). The common origin was with the obturator artery in 12 cases and with the internal pudendal artery in one case. The Angle of origin of the uterine artery with the main segment of origin on the right side showed a mean value of 53.2°(SD: 25.23, Range: 0° – 98°), in 2 arteries the uterine artery showed an angle of origin of 0° since the uterine artery was the direct continuation of the main stem of origin. On the left side the angle showed a mean value of 54.8° (SD: 17.72, Range: 19° – 91°) Schlussfolgerung: The uterine artery arises typically directly from the anterior division of the IIA. Atypical origins should be searched for when the artery could not be found in its typical location.
Korrespondierender Autor: Naguib NN
Johann Wolfgang Goethe Universitätsklinikum, Institut für diagnostische und interventionelle Radiologie, Theodor-Stern-Kai 7, 60596 Frankfurt am Main
E-Mail: nagynnn@yahoo.com
Uterine Artery - Embolization - MRA