CT manifestations of various types of uterine fibroids

Uterine fibroids are the most common benign tumors of the female reproductive system. They can be divided into intramural fibroids, subserosal fibroids, and submucosal fibroids according to their relationship with the uterine muscle wall. The CT manifestations of various types of fibroids include the following:

1. Submucosal fibroids

Submucosal fibroids CT manifestations are enlarged uterus, smaller uterine cavity, and a round mass with roughly the same density as the uterus can be seen in the enlarged uterine cavity. Enhanced scanning shows significant and uniform enhancement of the mass, and a "pseudocapsule" can be seen at the edge. However, it is difficult to distinguish uterine hypertrophy, uterine body cancer, and adenomyosis on plain CT scans, so enhanced scanning is helpful for diagnosis.

2. Subserosal fibroids

CT shows an extrauterine mass with clear edges. Due to poor blood supply, most plain scans show mixed density, and the neutral degeneration and necrotic parts show low density. When the base of the mass is connected to the uterus, the CT appearance of subserosal uterine fibroids is similar to that of intramural fibroids. When subserosal fibroids show an extrauterine solid mass on CT, it should be differentiated from ovarian malignant tumors and ovarian endometriosis cysts.

3. Intramural fibroids

Intramural fibroids often cause uneven enlargement and deformation of the uterus, localized bulges, and smaller uterine cavity. Since most intramural fibroids change the uterine contour, it is not easy to miss them on plain scans. After enhanced scanning, the fibroids are significantly enhanced uniformly or unevenly, with vortex-shaped and small patchy low density inside, and "pseudocapsules" around them. Such fibroids should be distinguished from adenomyosis and uterine body cancer.