Uterine artery embolization combined with percutaneous microwave ablation for the treatment of prolapsed uterine submucosal leiomyoma: A case report

Figure 2 Ultrasound imaging before, during and after treatment. A: B-mode ultrasound imaging (longitudinal section) demonstrates a homogeneous hypoechoic mass (bold arrow) prolapsing into the cervical canal; B: Color Doppler flow imaging reveals a large blood vessel (bold arrow) in the pedicle supplying the whole myoma; C: contrast-enhanced ultrasound imaging shows high enhancement in the pedicle, suggesting that it is the main blood supply source of the prolapsed lesion; D: Two days after UAE, both the uterus and myoma show slight atrophy; E: The upper segment of the pedicle shows enhancement on contrast-enhanced ultrasound imaging (bold arrow), indicating partial recanalization of the feeding arteries; F: During the PMWA procedure, the microwave antenna (white line) was inserted into the pedicle precisely under real-time TAUS guidance; G: After thorough ablation of both the pedicle stump and the endometrium, a hyperechoic cloud covering the whole uterine cavity (arrows) is observed; H: Intraoperative contrast-enhanced ultrasound imaging shows no enhancement in the pedicle stump or the inner myometrium (arrows). UAE: Uterine artery embolism; PMWA: Percutaneous microwave ablation.