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Título

REPORTING UTERINE FIBROID IN ULTRASOUND EXAMINATION: A PROPOSAL AND PICTORIAL GUIDE FOCUSED ON SURGICAL PLANNING.

Introdução e Objetivos

Uterine fibroids are the most common benign gynecologic tumors in women of reproductive age and ultrasound is the first-line imaging modality for the diagnosis and characterization of these uterine fibroids. The classification of the International Federation of Gynecology and Obstetrics (FIGO) was developed to describe and classify uterine fibroids more uniformly and consistently. The correct description of fibroids in the ultrasound report is essential for planning surgical treatment and preventing complications. In this article, we review the sonographic findings of fibroids, detailing the main key points to be reported for pre-surgical evaluation. In addition, we present a structured and illustrated report template to describe fibroids based on the critical points of surgical planning.
Study Objectivo: To illustrate the main findings to be reported in the ultrasound report and, additionally, to propose a structured report of transvaginal ultrasounds for pre-surgical evaluation of patients with uterine fibroids.

Casuística e Métodos

Classically, ultrasound imaging of uterine fibroids is characterized as a solid, rounded, well-defined hypoechoic, heterogeneous lesion within the myometrium, often showing shadows at the edge of the lesion and/or an internal fan-shaped shadow . On color Doppler, the circumferential flow around the lesion is often visible. In addition to revealing the vascularity of fibroids, a study by Fleischer and his colleagues demonstrated that hypervascular fibroids on color Doppler ultrasound have more reduction in size than isovascular or hypovascular fibroids after uterine artery embolization, And postprocedure sonographic imaging showed decreased uterine size and echogenicity and Color Doppler imaging showed a marked decrease in the blood flow to the leiomyoma

Descrição das Imagens, Comentários e/ou Discussão

Classically, ultrasound imaging of uterine fibroids is characterized as a solid, rounded, well-defined hypoechoic, heterogeneous lesion within the myometrium, often showing shadows at the edge of the lesion and/or an internal fan-shaped shadow

Considerações Finais ou Conclusões

There are key points in the characterization of fibroids that help gynecologists in planning surgical treatment and have the potential to avoid possible complications and treatment failure. The proposal of a structured and illustrated report model to describe fibroids based on these critical points can improve patient counseling and treatment planning, including the selection of the most appropriate medical or surgical therapeutic strategy.

Palavras Chave

Ultrasonography; Leiomyoma; Myoma; Myomectomy; Infertility.

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