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Figure 12c. Uterine necrosis. (a) Sagittal fast SE T2-weighted MR image (5700/81) obtained prior to UAE shows low-signal-intensity fibroids (F) embedded within the myometrium. (b) On an axial gadolinium-enhanced fat-suppressed gradient-echo T1-weighted MR image (180/1.5, 90° flip angle) obtained prior to UAE, both the index fibroid (F) and the adjacent myometrium (M) demonstrate enhancement. (c) On a sagittal fast SE T2-weighted MR image (6000/85) obtained 4 days after UAE, the myometrium has diffusely higher signal intensity than the index fibroid (F). (d) Delayed sagittal gadolinium-enhanced fat-suppressed gradient-echo T1-weighted MR image (195/1.6, 90° flip angle) shows no enhancement of the fibroids, endometrium, or myometrium, a finding that is consistent with uterine necrosis (N). Note the peripheral area of enhancement (arrow), a finding that is thought to represent a serosal rim of viable myometrium. (Reprinted, with permission, from reference 43.)
