How does a woman know if she has fibroids? Sometimes, fibroids can be felt through the skin. However, most commonly they are felt on the physical exam during medical evaluation and/or confirmed by a pelvic ultrasound exam.
Pelvic ultrasound is an imaging tool that is based on sound waves similar to what submarines use to “see” underwater. Sound waves are emitted from a probe that is either placed on the skin (transabdominal probe) or inserted in the vagina (transvaginal probe). These waves are absorbed and reflected back and received by the probe. A computer within the ultrasound machine turns this information into images that are displayed on a black and white screen.
The resolution of the ultrasound machines is significantly lower than the pelvic MRI. In the past, the cost of the MRI was significantly higher than ultrasound and that often prevented people from using pelvic MRI more often. The cost of MRI has dropped significantly; particularly if the imaging is done in a facility that is not hospital-owned. In addition, ultrasound machines are practically in every Gynecologist’s office and this also facilitated its use over MRI. Pelvic MRI is becoming increasingly popular particularly in the evaluation of pelvic masses.
The higher resolution of MRI is important in women that are interested in Uterine Fibroid Embolization (UFE) to ensure that she is a candidate for this procedure. The higher resolution of MRI will also pick up extrauterine disease that may delay or disqualify the patient from proceeding with UFE. It also can distinguish between fibroids and adenomyosis which is commonly missed on pelvic ultrasound examinations.
The left figure shows a typical sagittal (side-view) pelvic ultrasound picture. A portion of the woman’s bladder is seen at the top of the image. Her uterus is the oval dark gray structure just below the bladder. The dark area that is being measured on the screen (x and + dotted lines) is a fibroid.
Compare that image to a typical sagittal pelvic MRI image (right figure). Notice the significantly higher resolution of this MRI image versus the ultrasound image. The bladder is the white oval structure. The uterus is immediately behind the bladder and contains a solitary fibroid (black circle). The other black linear structures near the top of the uterus and directly behind it are loops of bowel.
If you are considering UFE (Uterine Fibroid Embolization) for the treatment of your uterine fibroids, you will need to undergo a pelvic MRI exam. Make an appointment with an experienced interventional radiologist Dr. John Lipman from Atlanta Fibroid Center.