Type:
Educational Exhibit
Keywords:
Education and training, Diagnostic procedure, Ultrasound, MR, CT, Genital / Reproductive system female
Authors:
A. Moussa, A. E. Syed, I. Caglič, P. Malcolm, S. scott-barrett; Norwich/UK
DOI:
10.1594/ecr2018/C-1213
Background
Leiomyomas are benign mesenchymal tumours of smooth muscle origin.
They mostly arise in the uterus in women of the reproductive age group.
Typical imaging findings vary depending on the modality used.
Ultrasound
Appearances are of a homogeneous hypoechoic mass,
with or without posterior acoustic shadowing depending on the contents.
On colour doppler,
they show marked peripheral flow,
with absent central flow.
CT
A leiomyoma is typically isodense to the myometrium on non contrast scan and display homogenous enhancement post contrast.
MRI
The mass is typically isointense to the myometrium on T1 and hypointense to the myometrium on T2.
They can show a hyperintense rim due to oedema.
T2 is the most useful sequence in diagnosing a leiomyoma.
In addition to uterine leiyomyomas,
they can also uncommonly occur at extrauterine locations and can thus represent a diagnostic dilemma.
We will show cases of such extrauterine locations and suggest multimodality imaging findings which may help distinguish these unusual presentations.
The cases we have included:
1) Urethral leiomyoma
2) Gastric leiomyoma
3) Intravenous leiomyoma
4) Benign metastasising leiomyoma in a pregnant uterus
5) Retroperitoneal leiomyoma