Learning objectives
– To provide a pictorial review of benign myometriallesions with pathologic correlation;
– To review the clinical manifestations,
radiological findings and differential diagnosis ofbenign myometrial pathology.
Background
- Although leiomyomas are the most frequent benign tumors of the myometrium,benign pathology of the myometrium includes several other entities;
- They should be considered asdifferential adenomyosis,
lipoleiomyomas and uterine contractions.
- Moreover,
it is important to be able to distinguish these conditions from endometrial and extrauterine disease,
in the case of submucosal and suberosal lesions,
respectively.
- Sometimes the differential diagnosis between all these entities may become a challege.
- Furthermore malignancy,
such as leiomyosarcoma,
must be excluded pre-surgically.
- MRI should be the...
Findings and procedure details
MRI Protocol -Benign Myometrial Pathology
In our service,
it is performed routinely the following protocol for suspected or follow-up of benign lesions of the myometrium:
Pelvis Sequences
- Axial T1 ( 5mm)
- Axial T2 ( 5mm)
Specific Sequences to the Uterus
- Sagittal T2 Body Uterus (4mm )
- Coronal T2 Body Uterus (4mm )
- Axial T2 Body Uterus (4mm )
Post Gadolinium Study
- Dynamic study - T1 * SPAIR – usually sagittal plane ( 5 purchases up to 150 sec.
)...
Conclusion
- Leiomyomas are the commonest uterine neoplasms;
- Althought they are frequently assymptomatic,
they maycause pelvic pain,menometrorrhagia and infertility and are the commonest indication for hysterectomy;
- To know the differential diagnoses ofbenignpathologyof themyometriumand their respective ultrasound and MRI findings,
becomes indispensable,
considering that leiomyomas may mimic a range of other pelvic disorders;
- MRI is the method of choice,
but radiologists should be aware of typical and unusual radiological findings of the differentbenignmyometriallesions and their mimics,
to enable prompt diagnosisand and correct therapeutic strategy.
References
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Cunha TM.Uterine sarcomas: clinical presentation and MRI features.Diagn Interv Radiol.
2014Oct 28.
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Wakely S,
Senior E,
Lomas D.
American Jounral of Roentgenology.
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Bhatnagar G,
Ramadhan FA,
Al-Zadjali N.
Arteriovenous malformation of uterus.
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(5)Teixeira Arildo Corrêa,
Urban Linei A.
B.
D.,
Zapparoli Mauricio,
Pereira Caroline,
Millani...