The two best radiology studies for evaluating the uterus for fibroids are Magnetic Resonance Imaging (MRI) and Ultrasound. Both have advantages and disadvantages. Ultrasound is less expensive and more accessible to people outside large urban areas.  MRI is superior to ultrasound at depicting characteristics of individual fibroids and the response of each fibroid to UFE. So superior that I presently insist that all of my patients have an MRI to help me determine if you are a candidate for UFE. MRI allows depiction of adenomyosis, a fairly common disease that can mimic fibroids by causing heavy menstrual bleeding and can expand the size of the uterus. Adenomyosis is frequently misdiagnosed as fibroids or missed altogether by ultrasound. 

On this page you will find examples of uterine ultrasound. Examples of MRI of the uterus are found on another page.

An ultrasound exam is performed by a technician or doctor who places a probe on your skin or in your vagina. The probe sends out harmless, high frequency sound waves and also listens for those sound waves as they bounce back from your body. Those echoes are transformed into an image by the ultrasound machine.

Here is an ultrasound demonstrating a large fibroid in a woman with heavy menstrual bleeding. The fibroid is outlined and shaded.

ultrasound before UFE

10 months after UFE, the fibroid has significantly decreased in size. Her abnormal bleeding stopped immediately following UFE.

10 months after UFE

Here are images from ultrasound studies before and 6 months after UFE.

A) Uterus as seen from midline, lengthwise, prior to UFE.

B) Uterus at widest cross sectional diameter, prior to UFE.

C) Uterus as seen from midline, lengthwise, 6 months after UFE. Compare to A.

D) Uterus at widest cross sectional diameter, 6 months after UFE. Compare to B.

The measurements of the uterus appear in the lower left corner of each image. The volume of the uterus, the space it takes up in the pelvis, the space that could be otherwise filled by your bladder or rectum, can be estimated using the formula for an ellipsoid: (LxHxW)(0.5233). A normal uterus will have a volume in the range of 150 to 250 cubic centimeters. In the above case, the uterine volume prior to UFE was (17.2x10.2x13.1)(.5233)=1,203 cubic centimeters. 6 months after UFE, that volume has decreased to (13.3x7.2x7.6)(.5233)=381 cubic centimeters. Her uterus decreased in volume by 68%. Typically it will continue to decrease in size over the next several months.

This patient had problems with heavy bleeding and pelvic fullness and pain. All of her symptoms resolved within days of her UFE. Even though her uterus remains abnormal by size criteria, it is no longer large enough to cause any symptoms. That is the goal of UFE: to relieve symptoms through a minimally invasive procedure. The above patient was particularly concerned about missing work, she was back at work one week after her UFE.


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This page was last updated on Sunday, May 20, 2012

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