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Comparison of MRI and Sonography in the Preliminary Evaluation for Fibroid Embolization

Audrey L. Spielmann1, Ciaran Keogh2, Bruce B. Forster1, Michael L. Martin1 and Lindsay S. Machan1

1 Department of Radiology, Vancouver Coastal Health Authority, University Hospital, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
2 British Columbia Cancer Agency, Vancouver, BC, Canada.


Figure 1
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  		Fig. 1 —Graph shows size discrepancy between MRI and sonography of maximal fibroid lengths of 122 fibroids.

 

Figure 2
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  		Fig. 2A —51-year-old woman with suspected uterine fibroids causing mass effect and menorrhagia. Sagittal transabdominal sonogram shows markedly enlarged fibroid (arrow) in uterus. Exact number, size, and location of fibroids are difficult to determine with accuracy.

 

Figure 3
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  		Fig. 2B —51-year-old woman with suspected uterine fibroids causing mass effect and menorrhagia. Coronal fast spin-echo T2-weighted image with fat saturation shows multiple large uterine fibroids, two of which are pedunculated subserosal fibroids (arrows) that were unsuspected on sonography. Larger pedunculated fibroid in fundus has broad stalk. Right-sided smaller pedunculated fibroid has narrow stalk. Additional large fibroid can be seen in uterine body and has considerable endometrial contact (arrowhead). Uterine artery embolization was denied because of MRI findings.

 

Figure 4
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  		Fig. 2C —51-year-old woman with suspected uterine fibroids causing mass effect and menorrhagia. Sagittal fast spin-echo T2-weighted image with fat saturation shows large pedunculated subserosal fundal fibroid with broad stalk (arrows). Large uterine body fibroid (arrowhead) is also seen.

 

Figure 5
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  		Fig. 3A —35-year-old woman presenting for evaluation of uterine fibroids. Sagittal transabdominal sonogram shows large uterine fibroid in lower uterine segment measuring 14.8 cm in maximal dimension (arrows). Fibroid was suspected to be paraendometrial in location. Arrowheads indicate endometrium in uterine body.

 

Figure 6
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  		Fig. 3B —35-year-old woman presenting for evaluation of uterine fibroids. Sagittal fast spin-echo T2-weighted image with fat saturation shows large fibroid predominantly in cervix but possibly also involving lower uterine segment (arrows). Arrowheads indicate endometrial cavity. MRI confirmed extensive contact with cervical canal. As a result, uterine artery embolization was not offered.

 

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