From the Guidelines
Uterine fibroids on ultrasound (US) typically appear as well-defined, hypoechoic or heterogeneous masses within the uterine wall, with characteristics that can guide management and treatment planning, as noted in the most recent guidelines 1. The ultrasound characteristics of uterine leiomyomas (fibroids) are crucial for diagnosis and treatment planning.
- They are usually round or oval in shape with distinct borders that distinguish them from surrounding myometrium.
- Fibroids may demonstrate posterior acoustic shadowing, particularly when calcified.
- Their echogenicity varies depending on the presence of degeneration, hemorrhage, or calcification, with most uncomplicated fibroids appearing hypoechoic compared to normal myometrium.
- On color Doppler imaging, fibroids generally show peripheral vascularity with blood vessels surrounding the mass rather than internal flow.
- Fibroids are classified by location as submucosal (projecting into the endometrial cavity), intramural (within the myometrial wall), or subserosal (projecting outward from the uterus), which is important for determining the best treatment approach, such as hysteroscopic resection or uterine fibroid embolization (UFE) 1.
- Size can range from a few millimeters to over 10 centimeters, and multiple fibroids are common, creating a "cobblestone" appearance of the uterus.
- Transvaginal ultrasound is preferred for detailed evaluation of smaller fibroids, while transabdominal ultrasound may be necessary for larger fibroids or an enlarged uterus that extends beyond the pelvis, although MRI is superior to US for identifying and mapping fibroids and may alter management in up to 28% of patients 1.
From the Research
Ultrasound Characteristics of Uterine Leiomyomas (Fibroids)
There are no research papers that directly describe the ultrasound characteristics of uterine leiomyomas (fibroids) among the provided studies 2, 3, 4, 5, 6.
Available Information on Uterine Fibroids
- Uterine fibroids are benign tumors that can cause significant morbidity, including heavy menstrual bleeding, pain, and pelvic pressure 2, 4, 5, 6.
- The treatment options for uterine fibroids include medical therapies, such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators, as well as surgical interventions, such as hysterectomy and myomectomy 2, 3, 4, 5, 6.
- High-Intensity Focused Ultrasound (HIFU) is also being explored as a non-surgical treatment option for uterine fibroids 3.
- The choice of treatment depends on the patient's personal treatment goals, as well as the efficacy and need for repeated interventions 4, 6.
Diagnosis and Management of Uterine Fibroids
- Uterine fibroids can be diagnosed using various methods, including ultrasound, and can be managed using a range of treatments, from painkillers and hormone therapy to surgical removal of the fibroids 5.
- The exact frequency of uterine fibroids varies depending on the diagnosis and population investigated, but it is estimated to affect up to 77% of reproductive women 5.