Accuracy of magnetic resonance imaging in assessing types of degeneration in leiomyomas

Abstract

Background: Leiomyomas are the most common benign uterine neoplasms arising from smooth muscle cells. Magnetic resonance (MR) imaging is the most accurate imaging technique for detecting and localizing leiomyomas. As leimyomas grow, they may outgrow their blood supply resulting in various types of degeneration such as myxoid, hyaline, cystic, red, and calcification. Degenerated leiomyomas have variable appearances on T2-weighted images and contrast-enhanced images. Materials and Methods: This was a retrospective hospital-based study done in Government Medical College, Srinagar, from January 2018 to December 2019. The study included 78 patients with more than 2 cm pathologically proven fibroids who underwent myomectomy or hysterectomy and preoperative MR imaging (MRI). We assessed the accuracy of MR for picking degeneration in fibroids. Aim and Objective: The aim and objective of this study is to determine the sensitivity, specificity, positive, and negative predictive value of MRI in assessing degeneration in uterine fibroids. Results: The sensitivity, specificity, positive and negative predictive values of MRI in assessing degeneration in uterine fibroids were 60%, 93.7%, 85.7%, and 78.9% respectively. Menorrhagia followed by dysmenorrhea was the most common presenting symptom. Conclusion: MRI has average sensitivity and very good specificity for picking fibroid degenerations. MRI has high accuracy for picking up myxoid, cystic, and red degeneration.

Keywords

• leiomyoma
• magnetic resonance imaging
• myxoid degeneration
• red degeneration