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Congress: ECR24
Poster Number: C-20313
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-20313
Authorblock: R. d. a. Omena, A. C. F. Rodrigues, L. D. S. Moreno, E. G. D. Oliveira Neto, T. V. Bertoncini, G. B. Costa Araújo, M. V. A. Soares; Federal district/BR
Disclosures:
Rafael de almeida Omena: Nothing to disclose
Ana Carolina Ferreira Rodrigues: Nothing to disclose
Lara De Souza Moreno: Nothing to disclose
Edinaldo Gomes De Oliveira Neto: Nothing to disclose
Tiago Vasques Bertoncini: Nothing to disclose
Gilberto Bruno Costa Araújo: Nothing to disclose
Mayra Veloso Ayrimoraes Soares: Nothing to disclose
Keywords: Abdomen, Genital / Reproductive system female, Pelvis, MR, Education, Cancer, Image registration, Neoplasia
Learning objectives - to identify the MRI characteristics of typical leiomyomas- to know the types of degeneration of leiomyomas and their imaging appearances on MRI- to recognize patterns of nodules with high suspicion of malignancy on MRI
Read more Background Uterine leiomyomas are highly prevalent, representing around 70-80% of  uterine neoplasms, they are hormonally dependent and usually involute after menopause. In contrast, leiomyosarcomas represent less than 1%, and a new or growth postmenopausal mass supports suspicion. Furthermore, the prevalence of malignancy increases when there are symptoms, such as abnormal uterine bleeding, abdominal distension, pelvic pain or urinary symptoms, however this does not confirm the diagnosis. Clinical and therapeutic strategies are dictated by the location, using FIGO classification and MRI signal,...
Read more Findings and procedure details 1-Leiomyoma:a) Localization:The FIGO classification system helps in the investigation of abnormal uterine bleeding, helps in planning and evaluating response to treatment of myomas. The main limitation of this classification is the interobserver variability in staging.According to this classification, myomas are divided into: Submucosal (FIGO stages 0–2), which can cause abnormal uterine bleeding, infertility and recurrent pregnancy loss regardless of size. Stage 0 have a risk of prolapse, depending on the location and length of the myoma stalk. Others: intramural (FIGO stages 3-5)...
Read more Conclusion It is essential to know the radiological patterns of leiomyoma and leiomyosarcoma to help the surgeon choose conservative surgeries, avoid dissemination with morcellation, avoid unnecessary hysterectomies when an atypical leiomyoma is suspected, and plan oncological procedures in selected cases.
Read more References Hindman N, Kang S, Fournier L, Lakhman Y, Nougaret S, Reinhold C, Sadowski E, Huang JQ, Ascher S. MRI Evaluation of Uterine Masses for Risk of Leiomyosarcoma: A Consensus Statement. Radiology. 2023 Feb;306(2):e211658. Tu W, Yano M, Schieda N, Krishna S, Chen L, Gottumukkala RV, Alencar R. Smooth Muscle Tumors of the Uterus at MRI: Focus on Leiomyomas and FIGO Classification. Radiographics. 2023 Jun;43(6):e220161. Munro MG, Critchley HO, Broder MS, Fraser IS; FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine...
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