تقييم الفحص بالرنين المغناطيسي والامواج فوق الصوتية بالمقارنة مع الفحص النسيجي لورم الرحم الليفي == Evaluation of Uterine Fibroid Using MRI & U/S with Histopathological Correlation
Author name:
زهراء هاشم محمود
Supervisor name:
ليث احمد طعمة
General topic:
Medicine
Specific topic:
Diagnostic Radiology
Degree:
Higher Diploma
University:
University of Baghdad - Faculty Of Medicine
Language:
English
University location:
Baghdad
First pages:
19T1594 - p.pdf
Abstract:
Uterine fibroids, also known as leiomyomas, are the commonest uterine neoplasm's about 30% - 40% in the reproductive age , Although benign, they can be associated with significant morbidity and are the commonest indication for hysterectomy, they are often discovered incidentally when performing imaging for other reasons, usually first identified by USG which the cheapest, easiest, safe during pregnancy, they can be further characterized by MRI, they are usually easily recognizable, but degenerate fibroids can have unusual appearance, MRI is informative in excluding associated Adenomyosis. AimTo evaluate US &MRI sequences in patients with leiomyoma about detection, number, mapping, characterization &associated other lesions correlated with histopathological result after surgical treatment.Patients & methods A prospective study was done in the Radiological department of BAGHDAD teaching hospital from September 2012 through May 2013, about 65 females patients where imaged by MRI after physical examination & US, where 45 patients did operation myomectomy or hysterectomy.Resultsage of patients 19 - 69 years mean age 39.4y, The women presented with menorrhagia and a variety of symptomes,45 patients where followed up by hysterectomy & myomectomy which inter really in my study ,the remaining (20 patients) non operative treated medically and followed up by US, MRI detect more than US in 60 fibroids which not detected by US being MRI more sensitive 98%, specific93% &accurate 97% than US ,also MRI more specific (93.9%)&more accurate 97%in detecting single &multiple fibroids than us with low specificity (50%)&accuracy (63.9%), also MRI more sensitive in detecting smaller fibroid <1cm 95.2% compared with US sensitivity 15.5%, about mapping US was 89%agree with histopathology results while MRI was more agreement with histopathology 98%, about 7 patients from 45(15.6%) was found to have Adenomyosis with fibroids which all of them diagnosed by MRI, we depend on T2 sequence in detecting fibroids which show about 80%hypointense, MRI cannot differentiate between the type of degeneration which about 2/3 degenerated , 44%show contrast enhancement which is not important in detection and characterization , in most of cases fibroids are iso to hypointense in T1.Conclusion : Superior sensitivity and minimal measurement discrepancies suggest MR imaging superior to US in evaluation for uterine fibroid especially pre surgical study &to exclude other causes of large uterus & should be preferentially utilizedfor assessing fibroids .
