Understanding Uterine Fibroids
& Their Sonographic
Appearances

By Natalia Vasquez BS,RDMS,RDCS
Uterine Fibroids
 Definition: Benign tumors that develop in the uterus
during childbearing years
 AKA: Leiomyoma's or ma...
Symptoms
 Asymptomatic
 Heavy menses bleeding
 Longer Menus periods
 Pelvic pain
 Frequent urination
 Rectal pressur...
Patient Preparation
1. Patient history- LMP, gravidity, parity, symptoms, previous
pregnancy complications, pervious lab r...
Types Of Fibroids
 Intramural Fibroids

 Subserosal Fibroids
 Submucosal Fibroids
 Pedunculated Fibroids
Sonogram Intermural Fibroid
Sonographic appearance:
• Round focal mass
• Located in uterine myometrium

Above: transverse ...
Subserosal Fibroid
 Project outside the uterus

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

 Press on bladder causing
a
urinary sympt...
Submusocal Fibroid
 Least common

 Located under the
endometrium
 Protrudes into uterine
cavity

 Cause heavy & long p...
Submusocal

Above: sagittal & right: transverse view
w/ hypoechoic submusocal fibroid
Predunculated Fibroid
 Attached to the uterus by a
stalk
 Located inside the uterus
or outside
Management Depends on …..
 Symptoms
 Location
 Size
 Number
 Age

 Reproductive plans
 Woman’s preferences
Treatment
 Gonadotropin-releasing hormone: Shrinks Fibroid
 Progestins/oral contraceptive pills/androgenic
agents/anti-e...
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“Understanding Uterine Fibriods &Their Sonographic Appearances”

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“Understanding Uterine Fibriods &Their Sonographic Appearances”

  1. 1. Understanding Uterine Fibroids & Their Sonographic Appearances By Natalia Vasquez BS,RDMS,RDCS
  2. 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. 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. 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. 5. Types Of Fibroids  Intramural Fibroids  Subserosal Fibroids  Submucosal Fibroids  Pedunculated Fibroids
  6. 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. 7. Subserosal Fibroid  Project outside the uterus  Press on bladder causing urinary symptoms  Press on rectum causing backache
  8. 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. 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. 10. Submusocal Above: sagittal & right: transverse view w/ hypoechoic submusocal fibroid
  11. 11. Predunculated Fibroid  Attached to the uterus by a stalk  Located inside the uterus or outside
  12. 12. Management Depends on …..  Symptoms  Location  Size  Number  Age  Reproductive plans  Woman’s preferences
  13. 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

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