CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2009; 19(03): 222-231
DOI: 10.4103/0971-3026.54887
Genito-Urinary Imaging

Radiological appearances of uterine fibroids

Sue Wilde
Department of Radiology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR4 7UY, United Kingdom
,
Sarah Scott-Barrett
Department of Radiology, Norfolk & Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR4 7UY, United Kingdom
› Author Affiliations

Abstract

Uterine fibroids, also known as leiomyomas, are the commonest uterine neoplasms. Although benign, they can be associated with significant morbidity and are the commonest indication for hysterectomy. They are often discovered incidentally when performing imaging for other reasons. Usually first identified with USG, they can be further characterized with MRI. They are usually easily recognizable, but degenerate fibroids can have unusual appearances. In this article, we describe the appearances of typical and atypical uterine fibroids, unusual fibroid variants and fibroid mimics on different imaging modalities. Knowledge of the different appearances of fibroids on imaging is important as it enables prompt diagnosis and thereby guides treatment.



Publication History

Article published online:
02 August 2021

© 2009. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Prayson RA, Hart WR. Pathologic considerations of uterine smooth muscle tumors. Obstet Gynecol Clin North Am 1995;22:637-57.
  • 2 Erdemoglu E, Kamaci M, Bayram I, Güler A, Güler. SH Primary giant leiomyoma of the ovary - case report. Eur J Gynaecol Oncol 2006;27:634-5.
  • 3 Cramer SF, Patel A The frequency of uterine leiomyomas. Am J Clin Pathol 1990;94:435-8.
  • 4 Day Baird D, Dunson DB, Hill MC, Cousins D, Schectman J. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol 2003;188:100-07.
  • 5 Marshall LM, Spieglman D, Barbieri RL, Goldman MB, Manson JE, Colditz GA, Willett WC, Hunter DJ. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol 1997;90:967-73.
  • 6 Rein MS, Barbieri RL, Friedman AJ. Progesterone: A critical role in the pathogenesis of uterine myomas. Am J Obstet Gynecol 1995;172:14-8.
  • 7 Walker CL, Stewart EA. Uterine Fibroids: The Elephant in the Room. Science 2005;308:1589-93.
  • 8 Murase E, Siegelman ES, Outwater EK, Perez-Jaffe LA, Tureck RW. Uterine Leiomyomas: Histopathologic Features, MR Imaging Findings, Differential Diagnosis and Treatment. Radiographics 1999;19:1179-97.
  • 9 Hutchins FL. Uterine fibroids diagnosis and indications for treatment. Obstet Gynecol Clin North Am 1995;22:659-65.
  • 10 Coronado GD, Marshall LM, Schwartz SM. Complications in pregnancy, labor, delivery with uterine leiomyomas: a population-based study. Obstet Gynecol 2000;95:764-9.
  • 11 Chaparala RPC, Fawole AS, Ambrose NS, Chapman AH. Large bowel obstruction due to a benign uterine leiomyoma. Gut 2004;53:386.
  • 12 Wallach EE, Vlahos NF. Uterine myomas: an overview of development, clinical features and management. Obstet Gynecol 2004;104:393-406.
  • 13 Worthington-Kirsch RL, Popsky GL, Hutchins FL. Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology 1998;208:625-9.
  • 14 Davis KM, Schlaff WD. Medical management of uterine fibromyomata. Obstet Gynecol Clin North Am 1995;22:727-38.
  • 15 Vitiello D, McCarthy S. Diagnostic imaging of myomas. Obstet Gynecol Clin N Am 2006;33:85-95.
  • 16 Paganeas E, Kier R, McCauley TR, McCarthy S. Submucosal uterine leiomyomas: diagnosis of prolapse into the cervix and vagina based on MRI imaging. AJR 1992;159:555-58.
  • 17 Roy C, Bierry G, El Ghali S, Buy X, Rossini A. Acute torsion of uterine leiomyoma: CT features. Abdom Imaging 2005;30:120-3.
  • 18 Ueda H, Togashi K, Konishi I, Kataoka ML, Koyama T, Fujiwara T, Kobayashi H, Fujii S, Konishi J. Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. Radiographics 1999;19:131-5.
  • 19 Okizura H, Sugimura K, Takemori M, Obayashi C, Kitao M, Ishida T. MR detection of degenerating uterine leiomyomas. J Comput Assist Tomogr 1993;17:760-6.
  • 20 Parker WH, FuYS, Berek JS. Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 1994;83:414-8.
  • 21 Leibsohn S, d′Ablaing G, Mishell DR, Schlaerth JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 1990;162:968-76.
  • 22 Cicinelli E, Romano F, Anastasio PS, Blasi N, Parisi C, Galantino P. Transabdominal sonohysteroscopy, transvaginal sonography and hysteroscopy in the evaluation of submucous fibroids. Obstet Gynecol 1995;85:42-7.
  • 23 Weinreb JC, Barkoff ND, Megibow A, Demopoulos R. The value of MR imaging in distinguishing leiomyomas from other solid pelvic masses when sonographyis indeterminate. AJR 1989;154:295-9.
  • 24 Ascher SM, Silverman PM. Applications of computed tomography in gynecologic diseases. Urol Radiol 1991;13:16-28.
  • 25 Weise M, Westphalen S, Fayyazi A, Emons G, Krauss T. Pseudo-Meigs Syndrome: Uterine Leiomyoma with Bladder Attachment Associated with Ascites and Hydrothorax - a Rare Case of a Rare Syndrome. Onkologie 2002;25:443-6.
  • 26 Dudiak CM, Turner DA, Patel SK, Archie JT, Silver B, Norusis M Uterine leiomyomas in the infertile patient: preoperative localization with MR imaging versus US and hysterosalpingography. Radiology 1988;167:627-63.
  • 27 Zawin M, McCarthy S, Scoutt LM, Comite F. High-field MRI and US evaluation of the pelvis in women with leiomyomas. Magn Resonance Imaging 1990;8:371-6.
  • 28 Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F. Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol 2002;186:409-15.
  • 29 Hricak H, Finck S, Honda G, Gφranson H. MR imaging in the evaluation of benign uterine masses: value of gadopentate dimeglumine-enhanced T1-weighted images. AJR 1992;158:1043-50.
  • 30 Mittl RL, Yeh IT, Kressel HY. High-signal-intensity rim surrounding uterine leiomyomas on MR images: pathologic correlation. Radiology 1991;180:81-3.
  • 31 Burn PR, McCall JM, Chinn RJ, Vashisht A, Smith JR, Healy JC. Uterine fibroleiomyoma: MR imaging appearance before and after embolization of uterine arteries. Radiology 2000;214:729-734.
  • 32 Maebayashi T, Imai K, Takekawa Y, Sasaki J, Otsuka H, Katsura Y, Mochizuki T.Radiologic features of uterine lipoleiomyoma. J Comput Assist Tomogr 2003;27:162-5.
  • 33 Avritscher R, Iyer RB, Ro J, Whitman G. Lipoleiomyoma of the uterus. AJR 2001;177:856.
  • 34 Pattani SJ, Kier R, Deal R, Luchansky E. MRI of uterine leiomyosarcoma. Magn Resonance Imaging 1995;13:331-3.
  • 35 Mark AS, Hricak H, Heinrichs LW, Hendrickson MR, Winkler ML, Bachica JA, Stickler JE. Adenomyosis and leiomyomas: differential diagnosis with MR imaging. Radiology 1987;163:527-9.
  • 36 Holloway BJ, Lopez C, Balogun M A simple and reliable way to recognize the transient myometrial contraction - a common pitfall in MRI of the pelvis. Clin Rad 2007;62:596-9.