Uterine Fibroids On MRI

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Uterine fibroids which are also called leiomyomas are the most common benign tumors of the uterus. They are often found on imaging studies of the pelvis such as MRI. Fibroids can be diagnosed on imaging studies although overlap in the appearance exists with other masses of the uterus.

Fibroid symptoms

They can be asymptomatic but can also cause problems such as pain, pressure, vaginal bleeding, and infertility. Uterine fibroids can sometimes be felt by your doctor when he examines you.

Uterine fibroids can be found in different parts of the uterus. Those which involve the uterine cavity can be especially problematic as they can cause vaginal bleeding, infertility and miscarriages.

Do uterine fibroids show up on MRI?

An MRI exam can provide a lot of detail about fibroids. MRI will show us the location of the fibroids in the uterus. MRI will provide detail about their appearance and if they have undergone degeneration. We can also see how much blood supply fibroids have by looking at the enhancement after contrast administration.

MRI can also help us when a mass is seen next to the uterus on an ultrasound exam. In these cases, it may not be clear whether it’s a fibroid or mass arising from the ovary. MRI can help distinguish the possibilities. The treatment is different for an ovarian mass.

Fibroid locations on MRI scan

Submucosal fibroids

These are fibroids which protrude into the uterine cavity or endometrium. These fibroids can cause problems with uterine bleeding, pain and fertility.

Intramural fibroids

These fibroids grow within the uterine muscular wall. These can cause symptoms of pain and bleeding.

Subserosal fibroids

These are fibroids which are located along the outer wall of the uterus. They can sometimes be pedunculated and on a stalk. They can cause pain and place pressure on other structures next to them.

Cervical fibroids

A rare location for uterine fibroids is the cervix.

What do fibroids look like on a MRI?

They are masses of varying size in the uterus. They can have different internal appearances on MRI. Fibroids often enhance after giving contrast because they receive blood supply.

Can MRI tell if a fibroid is cancerous?

Not reliably. Fortunately, transformation into cancer (leiomyosarcoma) is rare.

What percentage of fibroids turn cancerous?

Less then one out of a thousand

Why do I need a MRI scan for fibroids?

MRIs are often ordered for treatment planning. This test is ordered before an interventional radiologist plans an embolization procedure to treat the fibroids.

In these cases, it is important to see where the fibroids are and whether they have a good vascular supply. This will help in determining whether you are a good candidate for the procedure and to assess future response to the treatment.

MRI can find another reasons for your pelvic symptoms since we image the entire pelvis. We can find an ovarian cyst or mass for example.

We can also find problems somewhere in your pelvis not related to the uterus and ovaries like the bowel or urinary tract.

When should you worry about fibroids?

When you get troublesome symptoms. This can include anemia from heavy fibroid bleeding. Feelings of pain and pressure. Problems with fertility or pregnancy. Problems with the bowel and urinary tract.

Fibroid treatment

Fibroids treatment can include medical options like hormone administration, minimally invasive procedures like fibroid embolization and surgery.