Ultrasonography of uterine leiomyomas: A prospective cross-sectional study

Abstract

ABSTRACT Background, Sonographic Features of Uterine Leiomyomas Location: Subserosal: Located on the outer surface of the uterus.Intramural: Located within the muscular wall of the uterus. Submucosal: Protrude into the uterine cavity, often causing more symptoms like heavy menstrual bleeding. Size: Leiomyomas can range from very small (a few millimeters) to very large (over 20 centimeters).Size measurement is important for monitoring growth over time. Echotexture: Typically, fibroids appear as well-circumscribed, hypoechoic (dark) or heterogeneous masses.They may have calcifications, which appear as bright echoes within the fibroid. Shape: Generally round or oval.The borders are usually well-defined. Cystic Degeneration: Some fibroids may show areas of cystic degeneration, which appear as anechoic (clear) regions within the mass. Vascularity: Color Doppler ultrasonography can assess the blood flow within and around the fibroid.This is useful for differentiating fibroids from other masses and for planning treatment options like uterine artery embolization. Aims and Objectives: To complement diagnostic hysteroscopy for the assessment of a submucosal leiomyoma, a three-dimensional (3D) TVS can be combined with saline instillation into the uterine cavity. Diagnostic hysteroscopy and TVS have a good overall agreement in the diagnosis of submucosal leiomyomas and in the assessment of fibroids’ myometrial extension. In this regard, 3D saline contrast Sono hysterography may provide even more information than traditional 3D TVS. Materials and Methods: This study was conducted in the department of radiology and was a cross-sectional study that lasted 3 months (November 10, 2022–March 10, 2023). The sample size for this study was determined using predefined exclusion and inclusion criteria. The study population included 30 females aged 20–50 who visited the Diagnostic Centre with complaints of abnormal menstrual bleeding or changes in menstrual cycles. Results: The majority of fibroids (78%), on USG, appeared hypoechoic, with the remainder (10%) appearing heterogeneous. Conclusion: Ultrasound has a high sensitivity and specificity in the diagnosing uterine leiomyoma.