Date post: | 07-May-2015 |
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Health & Medicine |
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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 mayomas
Incidence: 4 out of 5 women More common in African AmericansUsually detected 30’s & 40’s yrs. of ageShrink after menopause
Symptoms Asymptomatic
Heavy menses bleeding
Longer Menus periods
Pelvic pain
Frequent urination
Rectal pressure / constipation
Bladder pressure / frequent urination
Back pain / leg pain
Infertility
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. Transducer- 1. Tranabdominal-3.0 MHz-5.0 MHz (5.0MHz for thin patients.
Curved linear array
2. Transvaginal- 5.0-7.0 MHz
Types Of Fibroids
Intramural Fibroids
Subserosal Fibroids
Submucosal Fibroids
Pedunculated Fibroids
Sonogram Intermural Fibroid
Above: transverse & below sagittal view demonstrates a small intermural fibroid located in fundus
Sonographic appearance: • Round focal mass• Located in uterine myometrium
• Most common• Grows within the myometrium • Can distort uterine shape
Subserosal Fibroid
Project outside the uterus
Press on bladder causing urinary symptoms
Press on rectum causing backache
Sonogram Subserosal Fibroid
Project outside the uterus
Press on bladder causing urinary symptoms
Press on rectum causing backache
Sonographic apprence: • L
ocated below the uterine skin
• Can distort the uterine contour
• May become predunctulated
Submusocal Fibroid
Least common
Located under the endometrium
Protrudes into uterine cavity
Cause heavy & long periods
Irregular bleedings
Fertility problems
Distort the endometrial line
Submusocal
Above: sagittal & right: transverse vieww/ 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
TreatmentGonadotropin-releasing hormone: Shrinks Fibroid
Progestins/oral contraceptive pills/androgenic agents/anti-estrogens: Controls heavy bleeding
SurgeryMyomectomy- only fibroid removedHysterectomy- uterus removed Uterine artery/fibroid embolization- blood is blocked
to fibroid MR-Guided focused ultrasound-energy to heat and
destroy causing shrinkage