Learning objectives
1- Reminderaboutradiological anatomy of the female pelvis.
2- Review FIGO classification of uterine fibroids.
3- Illustrate the various radiological aspects of uterine myomas,
studying selected cases of MRI.
Background
Uterine fibroids,
also known as leiomyomas,
are the most common uterine tumors in women of childbearing age,
and occur in approximately 50% of patients over the age of 40.
Although benign,
they can be associated with significant morbidity,
and present a frequent indication for hysterectomy,
especially in case of recurrent menorrhagia.
Most leiomyomas are asymptomatic,
howerver they may cause abnormal uterine bleeding,
pelvic pain,
infertility,
or a palpable abdominopelvic mass.
Their management remains critical,
since it is dealing with young patients of childbearing age,
and...
Findings and procedure details
1.
Reminder of the radiological anatomy of the uterine cavity:
Uterus occupies a medial and subperitoneal position in the female pelvis,
just behind the bladder and in front of the rectum.
It is a fibromuscular organ,
divided into three main anatomic segments (from superior to inferior): the fundus,
corpus (body),
and cervix(extends into the vagina).
Several ligaments support the uterine cavity,
including the utero-ovarian ligament,
the roundligament,
the broad ligament,
the cardinal ligament and the uterosacral ligament. Fig. 1
Broad ligament:
The broad ligament of...
Conclusion
Currently, MRI is the preferred imaging modality for uterine fibroids characterization thanks to its morphological and dynamic studies (Enhancement and Diffusion-MRI (DWI)).
It provides a detailed mapping of uterine leiomyomas,
predicts malignancy and atypia signs.
Thus,
it has an essential place,
guiding the therapeutic management.
Personal information
Uterine fibroid in all its states :MRI findings.
H.
Hriz1,
E.
Younsi2,
E.
Ezzedine1,
Z.
Zaimi1,
S.
Mghaieth3,
N.
Achour1,
A.
Ben Miled1,
N.
Mnif1;1Tunis/TN,2Montfleury/TN,3Tunis,
tunis/TN
References
Rahel A,
and al: European Society of Urogenital Radiology (ESUR) Guidelines,
Eur Radiol 2018,10.1007/s00330-017-5157-5.
Wilde S, and al: Radiological appearances of uterine fibroids,Indian J Radiol Imaging,
2009,IP: 78.181.101.9.
Jacques D,
and al: Uterine fibroid management from the present to the future,
Oxford University Press on behalf of the European Society of Human Reproduction and Embryology,2016,665–686.
Aki K,
and al: Uterine anatomy and function on cine magnetic resonance imaging,Reprod Med Biol,
2016,
15:191–199.
Elizabeth Kagan A,
and al:Review of Leiomyoma Variants,AJR,
2015, 205:912–921.
James E,
and...