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“Understanding Uterine Fibriods &Their Sonographic Appearances”

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  • 1.Understanding Uterine Fibroids & Their Sonographic AppearancesBy Natalia Vasquez BS,RDMS,RDCS

2. 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 Americans Usually detected 30s & 40s yrs. of age Shrink after menopause 3. Symptoms Asymptomatic Heavy menses bleeding Longer Menus periods Pelvic pain Frequent urination Rectal pressure / constipation Bladder pressure / frequent urination Back pain / leg pain Infertility 4. 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 bladder4.Transvaginal5.Patient position- Supine, Semi flower6.Transducer1. 2.Tranabdominal-3.0 MHz-5.0 MHz (5.0MHz for thin patients. Curved linear array Transvaginal- 5.0-7.0 MHz 5. Types Of Fibroids Intramural Fibroids Subserosal Fibroids Submucosal Fibroids Pedunculated Fibroids 6. Sonogram Intermural Fibroid Sonographic appearance: Round focal mass Located in uterine myometriumAbove: transverse & below sagittal view demonstrates a small intermural fibroid located in fundus Most common Grows within the myometrium Can distort uterine shape 7. Subserosal Fibroid Project outside the uterus Press on bladder causing urinary symptoms Press on rectum causing backache 8. Sonogram Subserosal Fibroid S o n o g r a p h i Project outside the uterus c Press on bladder causing a urinary symptoms p p Press on rectum causing r backache e n c 9. Submusocal Fibroid Least common Located under the endometrium Protrudes into uterine cavity Cause heavy & long periods Irregular bleedings Fertility problems Distort the endometrial line 10. SubmusocalAbove: sagittal & right: transverse view w/ hypoechoic submusocal fibroid 11. Predunculated Fibroid Attached to the uterus by a stalk Located inside the uterus or outside 12. Management Depends on .. Symptoms Location Size Number Age Reproductive plans Womans preferences 13. Treatment Gonadotropin-releasing hormone: Shrinks Fibroid Progestins/oral contraceptive pills/androgenic agents/anti-estrogens: Controls heavy bleeding Surgery Myomectomy- only fibroid removed Hysterectomy- uterus removed Uterine artery/fibroid embolization- blood is blocked to fibroid MR-Guided focused ultrasound-energy to heat and destroy causing shrinkage