Features of mri imaging of uterine fibroids in the preoperative stage

Dmytro M. Zhelezov

Summary. Uterine fibroids are benign monoclonal tumors of uterine smooth muscle, which usually have multiple multimodal nature, but can also occur in the form of single fibroids. Uterine leiomyoma is one of the most common gynecological diseases in women and is of reproductive age, according to various authors, from 10 to 40 %. The aim of the study – to assess the diagnostic value of MRI imaging of uterine fibroids in the preoperative stage. Materials and Methods. The study was performed on the basis of the Regional Perinatal Center and the Maternity Hospital No. 5 (Odesa). 35 women with uterine fibroids detected by ultrasound were examined. All patients underwent MRI examination using Siemens Symphony (Germany). Subsequently, patients underwent surgery: in 20 cases conservative myomectomy in 15 – hysterectomy. Statistical processing was performed by analysis of variance using Statistica 13.5 software (StatSoft Inc., USA). Results. Comparing the results of MRI examination with the data of previous ultrasound screening and histological analysis of myomas removed during surgery, it was found that the specificity of the MRI method is 100 %, sensitivity – 97.1 %, which corresponds to the Juden coefficient J = 0.97. Conclusions. MRI examination has a high diagnostic value and can be recommended to clarify the diagnosis in complex clinical cases. The most common hyperdensive myomas with low intensity of contrast accumulation

[1] De La Cruz MS, Buchanan EM. Uterine fibroids: diagnosis and treatment. Am Fam Physician. 2017;95(2): 100-7. Available from: https://www.aafp.org/afp/2017/0115/p100.html.

[2] Stewart EA, Laughlin-Tommaso SK, Catherino WH, Lalitkumar S, Gupta D, Vollenhoven B. Uterine fibroids. Nat Rev Dis Primers. 2016;2:16043. Available from: https://doi.org/10.1038/nrdp.2016.43.

[3] Al-Hendy A, Myers ER, Stewart E. Uterine fibroids: burden and unmet medical need. Semin Reprod Med. 2017;35(6): 473-80. Available from: https://doi.org/10.1055/s-0037-1607264.

[4] Yu O, Reed SD, Schulze-Rath R, Grafton J, Hansen K, Scholes D. Identification of incident uterine fibroids using electronic medical record data. EGEMS (Wash DC). 2019;7(1): 5. Available from: https://doi.org/10.5334/egems.264.

[5] Lauterbur P. Image formation by induced local interactions: examples employing nuclear magnetic resonance. Nature. 1973;242:190-1. Available from: https://doi.org/10.1038/242190a0.

[6] Macchia RJ, Termine JE, Buchen CD. Raymond V. Damadian, M.D.: magnetic resonance imaging and the controversy of the 2003 Nobel Prize in Physiology or Medicine. J Urol. 2007;178(3 Pt 1): 783-5. Available from: https://doi.org/10.1016/j.juro.2007.05.019.

[7] Ichikawa S, Motosugi U, Omori M, Sano K, Omiya Y, Hirata S, Onishi H. MR-guided focused ultrasound for uterine fibroids: a preliminary study of relationship between the treatment outcomes and factors of mr images including elastography. Magn Reson Med Sci. 2019;18(1): 82-7. Available from: https://doi.org/10.2463/mrms.tn.2017-0103.

[8] Kalina I, Tóth A, Valcseva É, Kaposi PN, Ács N, Várbíró S, Bérczi V. Prognostic value of pre-embolisation MRI features of uterine fibroids in uterine artery embolisation. Clin Radiol. 2018;73(12): 1060.e1-e7. Available from: https://doi.org/10.1016/j.crad.2018.08.009.

[9] Tsai LL, Grant AK, Mortele KJ, Kung JW, Smith MP. A practical guide to MR imaging safety: what radiologists need to know. Radiographics. 2015;35(6): 1722-37. Available from: https://doi.org/10.1148/rg.2015150108.