Ultrasonography of Uterine Leiomyomas

Sabrina Q. Rashid, Yi‐Hong Chou, Chui‐Mei Tiu
In: Journal of Medical Ultrasound · 2016 · vol. 24(1) , pp. 3–12 · doi:10.1016/j.jmu.2015.12.006 · W2345211523
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Ultrasonography of uterine leiomyomas reveals well-defined masses with variable echogenicity and posterior shadowing, though degeneration can complicate diagnosis, sometimes requiring MRI.

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Abstract

Leiomyomas or myomas of the uterus, also known as a fibroid uterus, are the most common tumors of the uterus. They are benign neoplasms of smooth muscle origin with various degrees of fibrous connective tissue. These tumors can develop in any part of the female genital tract where there is smooth muscle or fibrous tissue, even in the ovary, broad ligament, and vagina. They need to be differentiated from adenomyosis and intracavitary polyps. They mostly remain asymptomatic but sometimes they cause significant morbidity. In such situations, hysterectomy or other surgical intervention is indicated. On ultrasonography, most uterine leiomyomas typically appear as well-defined, solid masses. Their echogenicity is usually similar to that of the myometrium, but sometimes they are hypoechoic. They often show some posterior acoustic shadowing. Variants of leiomyomas occur when they undergo cystic degeneration, hyalinization, or calcification. In such situations, determining a diagnosis is sometimes difficult. Magnetic resonance imaging can be used in this situation for an accurate diagnosis.

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adenomyosis

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