Diagnostic Imaging for Uterine Fibroids, Adenomyosis, and Uterine Sarcomas

  • Aki KidoEmail author
Part of the Comprehensive Gynecology and Obstetrics book series (CGO)


The main role of imaging for uterine mesenchymal tumors is to make an accurate diagnosis of each tumor, especially differentiating malignant tumors from benign ones. Because of the superior spatial resolution of MR imaging compared to ultrasound and computed tomography, detailed information related to the disease is often obtained from MR imaging. For uterine leiomyoma, or fibroid, it is necessary to know the variation of image findings of leiomyoma such as edema, myxoid change, and several variants of leiomyoma. Because most of the degenerated leiomyomas and variants show high signal intensity on T2-weighted image of MRI, a key sequence for diagnosing uterine tumor is T2-weighted image. That knowledge of variation is important for differentiation from sarcomas, especially leiomyosarcoma and low-grade endometrial stromal sarcoma. Typical features of leiomyosarcoma are hemorrhage and necrosis within the tumor. They are reflected as irregularly unenhanced lesion with high signal intensity on T1-weighted image. In cases of adenomyosis, hemorrhagic foci or dilated cystic glands within the heterotopic endometrial tissue are visualized as cystic lesions both on US and MRI. Adenomyosis also receives hormonal influence by hormonal therapy or pregnancy. Those changes were visualized using MR imaging.


MRI Uterine fibroid/leiomyoma Uterine sarcoma 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan

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