Learning objectives
Discuss the clinical and imaging feature of tipical presentation forms of leiomyomas.
Describe another entities that may resemble leiomyomas in the female pelvis.
Background
Uterine leiomyomas,
also known as myomas or fibroids,
are the most common gynecologic neoplasm,
affecting up 20% to 50% of women in reproductive age.
They are benign monoclonal tumors arising from the smooth muscle cells of the myometrium.
Typically present with menorrhagia,
pelvic pain and mass effect,
and in some cases,
may cause reproductive or sexual dysfunction.
These tumours occur in different sites within the uterus and can be classified as submucosal,
intramural or subserosal. As they enlarge they may outgrow their blood supply,
resulting...
Findings and procedure details
Magnetic resonance (MR) is the most accurate imaging technique for detection and localization of leiomyomas due to its excellent capability to demonstrate the uterine zonal anatomy that enables accurate classification of individual masses as submucosal,
intramural,
or subserosal.
The imaging is quite variable depending of the type of degeneration,
typically the leiomyomas demonstrate distinct low signal intensity relative to that of the myometrium on T2-weighted images,
an intermediate signal intensity on T1-weighted images and demonstrate enhancement on contrast–enhanced images.
These characteristic signal intensities are attributed...
Conclusion
Leiomyomas are the most common benign gynecologic neoplasm.
They can have vary widely MR imaging appearances that may present a diagnostic problem.
It is important to be familiar with the image featuring to distinguish them from other pathologies,
since it affects the therapeutic management of the patient.
References
(1)Ueda H,
Togashi K,
Konishi I,
et al.
Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds.
RadioGraphics 1999; 19: 131-145.
(2)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.
(3)Dueholm M,
Lundorf E,
Hansen ES,
Ledertoug S,
Olsen F.
Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis,
mapping,
and measurement of uterine myomas.
Am J Obstet Gynecol 2002; 186: 409-415.
(3)Vitiello D,
McCarthy S....