“Understanding Uterine Fibriods &Their Sonographic Appearances”

1. Understanding Uterine Fibroids
& Their Sonographic
Appearances
By Natalia Vasquez BS,RDMS,RDCS

2. Uterine Fibroids
 Definition: Benign tumors that develop in the uterus
during childbearing years
 AKA: Leiomyoma's or mayomas
 Incidence:




4 out of 5 women
More common in African Americans
Usually detected 30’s & 40’s yrs. of age
Shrink after menopause

3. Symptoms
 Asymptomatic
 Heavy menses bleeding
 Longer Menus periods
 Pelvic pain
 Frequent urination
 Rectal pressure / constipation
 Bladder pressure / frequent urination
 Back pain / leg pain
 Infertility

4. Patient Preparation
1. Patient history- LMP, gravidity, parity, symptoms, previous
pregnancy complications, pervious lab results, history of
pelvic surgery
2. Written request for examination
3.
Transabdominal- Full bladder
4.
Transvaginal
5.
Patient position- Supine, Semi flower
6.
Transducer1.
2.
Tranabdominal-3.0 MHz-5.0 MHz (5.0MHz for thin patients.
Curved linear array
Transvaginal- 5.0-7.0 MHz

5. Types Of Fibroids
 Intramural Fibroids
 Subserosal Fibroids
 Submucosal Fibroids
 Pedunculated Fibroids

6. Sonogram Intermural Fibroid
Sonographic appearance:
• Round focal mass
• Located in uterine myometrium
Above: transverse & below sagittal view
demonstrates a small intermural fibroid located in
fundus
• Most common
• Grows within the myometrium
• Can distort uterine shape

7. Subserosal Fibroid
 Project outside the uterus
 Press on bladder causing
urinary symptoms
 Press on rectum causing
backache

8. Sonogram Subserosal Fibroid
S
o
n
o
g
r
a
p
h
i
 Project outside the uterus
c
 Press on bladder causing
a
urinary symptoms
p
p
 Press on rectum causing
r
backache
e
n
c

9. Submusocal Fibroid
 Least common
 Located under the
endometrium
 Protrudes into uterine
cavity
 Cause heavy & long periods
 Irregular bleedings
 Fertility problems
 Distort the endometrial line

10. Submusocal
Above: sagittal & right: transverse view
w/ hypoechoic submusocal fibroid

11. Predunculated Fibroid
 Attached to the uterus by a
stalk
 Located inside the uterus
or outside

12. Management Depends on …..
 Symptoms
 Location
 Size
 Number
 Age
 Reproductive plans
 Woman’s preferences

13. Treatment
 Gonadotropin-releasing hormone: Shrinks Fibroid
 Progestins/oral contraceptive pills/androgenic
agents/anti-estrogens: Controls heavy bleeding
 Surgery
 Myomectomy- only fibroid removed
 Hysterectomy- uterus removed
 Uterine artery/fibroid embolization- blood is blocked to
fibroid
 MR-Guided focused ultrasound-energy to heat and destroy
causing shrinkage