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Related Experiment Videos

Acoustic shadowing from uterine leiomyomas: sonographic-pathologic correlation

M A Kliewer1, B S Hertzberg, P Y George

  • 1Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.

Radiology
|July 1, 1995
PubMed
Summary

Discrete shadowing on ultrasound (US) of uterine leiomyomas originates from structural transitions, not echogenic sources. These shadows arise from fibroid margins, smooth muscle whorls, or connective tissue interfaces, aiding in diagnosis.

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Area of Science:

  • Radiology
  • Pathology
  • Gynecologic Imaging

Background:

  • Ultrasound (US) is crucial for characterizing uterine leiomyomas.
  • Discrete shadowing in leiomyomas can be challenging to interpret.
  • Understanding shadowing origins improves diagnostic accuracy.

Purpose of the Study:

  • To determine the source of discrete shadowing in uterine leiomyomas that lacks an echogenic origin.
  • To correlate US findings with histopathologic features.

Main Methods:

  • Seven hysterectomy specimens with leiomyomas were examined using ultrasound.
  • Needles guided by US localized the origin of non-echogenic shadows.
  • Localized tissues underwent gross and microanatomic examination.

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Main Results:

  • In 12 of 13 cases, shadows originated from transitional zones: fibroid-myometrium margins, smooth muscle whorls, or smooth muscle-hyalinized connective tissue interfaces.
  • No calcification, hemorrhage, or necrosis was observed in these 12 cases.
  • One case showed microcalcifications as the shadow source.

Conclusions:

  • Discrete US shadowing in uterine leiomyomas, when not from echogenic foci, stems from the leiomyoma's inherent structural characteristics.
  • These shadows occur at boundaries between different tissue types or along curved anatomical structures within the leiomyoma.