Alice Cristina Coelho Brandao MD, Presenter: Nothing to Disclose

Gisele Esteves Annunciacao MD, Abstract Co-Author: Nothing to Disclose

Lara Alexandre Brandao MD, Abstract Co-Author: Nothing to Disclose

Paulo R Barrozo MD, Abstract Co-Author: Nothing to Disclose

Ricardo Lasmar MD, Abstract Co-Author: Nothing to Disclose

Luiz Felippe Mattoso MD, Abstract Co-Author: Nothing to Disclose

Define by using the MR findings, which submucosus leiomyoma can be treated with hysteroscopy.

After the diagnosis of submucosal leiomyoma at the hysteroscopy, fifty patients underwent MR imaging. The data were obtained from August 2000 to January 2004 with pelvic phased array GE 1,5-T Signa Horizon. High resolution axial, oblique coronal and sagital FRFSE T2-weighted and T1-weighted fat-supression before and after gadolinium were acquired. The parameters were defined by one radiologist and the gynecologist that performed the hysteroscopy. Both methods evaluated size, implantation base, intramural component, localization, distance to serosa and number. We used the submucosal leiomyoma hysteroscopic european endoscopy surgery society classification to both exams: level 0-entirely endocavity; level 1-intramural component 50%.

The most important MR characteristics of submucosal leiomyomas candidates for hysteroscopy resection were size, miometrial penetration (intramural component), implantation base and leiomyoma distance to serosa. The median submucosal leiomyoma volume and implantation base determines the possibility of endocavity adherence. The distance to serosa identified just at MR images with high accuracy is very important. The distance < 12 mm limits hysterospic ressection. The MR images changed 17 in the fifty submucosal leiomyoma hysteroscopic classification with large leiomyomas, deep implanted and level 1 and 2 hysteroscopic european endoscopy surgery society classification. These leiomyomas arenīt candidates for histeroscopy resection.

The aspects of submucosal leiomyomas have clinical signifance and change the treatment. MR imaging is a accurate imaging technique for localization of submucosal uterine leiomyomas and can determine which can be treated with hysteroscopy. The most important MR characteristics of candidates for hysteroscopy resection were size, miometrial penetration, implantation base and distance to serosa. The MR findings upgraded large leiomyomas, deep implanted and level 1 and 2 hysteroscopic european endoscopy surgery society classification.

Brandao, A, Annunciacao, G, Brandao, L, Barrozo, P, Lasmar, R, Mattoso, L, What Does the Gynecologist Need to Know from MR Images to Treat the Submucosus Leiomyoma?.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4414406.html