CT features of submucosal uterine fibroids

Uterine fibroids can be divided into intramural fibroids, subserosal fibroids and submucosal fibroids according to their relationship with the uterine muscle wall. Among them, subserosal fibroids are uterine fibroids that grow toward the serosa and protrude from the surface of the uterus. The surface of the fibroid is only covered by the uterine serosa. It is a substantial mass, accounting for about 20% to 30% of the incidence of fibroids.

When a subserosal fibroid is seen, the mass is usually large, with a wide or narrow base, or even connected to the uterus with a pedicle. The shape is often irregular, with clear boundaries with surrounding tissues. If the pedicle is not well supplied with blood, the fibroid may become necrotic; if the pedicle is twisted and broken, the fibroid will fall off to form a free fibroid; if the fibroid is located on both sides of the uterine body and grows to the side of the uterus and protrudes between the two layers of the broad ligament, it is called a broad ligament fibroid.

When the mass has a thin pedicle or breaks off to form a parasitic uterine fibroid, it is difficult to differentiate it from an ovarian tumor by B-ultrasound. CT plain scan plus enhanced scan has a higher value in the diagnosis of uterine fibroids. The CT manifestations of this type of fibroids are: an extrauterine mass with clear edges. Due to poor blood supply, most plain scans show mixed density, and neutral degeneration and necrotic parts show low density. When the wide base of the mass is connected to the uterus, the CT manifestations of subserosal uterine fibroids are similar to those of intramural fibroids. When subserosal fibroids show an extrauterine solid mass on CT, it should be distinguished from ovarian malignancies and ovarian endometriosis cysts.