Reporting of uterine fibroids on ultrasound examinations: an illustrated report template focused on surgical planning

Palheta, Michel Santos; Medeiros, Francisco das Chagas; Severiano, Ana Roberta Gomes

doi:10.1590/0100-3984.2022.0048

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Sumário

Review Article • Radiol Bras 56 (2) • Mar-Apr 2023 • https://doi.org/10.1590/0100-3984.2022.0048 copy

Reporting of uterine fibroids on ultrasound examinations: an illustrated report template focused on surgical planning

Relato de miomas uterinos em exames de ultrassonografia: um modelo de relatório ilustrado com foco no planejamento cirúrgico

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Uterine fibroids are the most common benign gynecologic tumors in women of reproductive age, and ultrasound is the first-line imaging modality for their diagnosis and characterization. The International Federation of Gynecology and Obstetrics developed a system for describing and classifying uterine fibroids uniformly and consistently. An accurate description of fibroids in the ultrasound report is essential for planning surgical treatment and preventing complications. In this article, we review the ultrasound findings of fibroids, detailing the main points to be reported for preoperative evaluation. In addition, we propose a structured, illustrated report template to describe fibroids, based on the critical points for surgical planning.

Keywords:
Ultrasonography; Leiomyoma; Myoma; Uterine myomectomy; Metrorrhagia; Infertility

Localization	Type	Description
Submucosal	0	Pedunculated intracavitary fibroid (i.e., submucosal fibroid without intramural extension)
	1	Submucosal fibroid with intramural extension < 50%
	2	Submucosal fibroid with intramural extension > 50%
Intramural	3	Intramural fibroid in contact with the endometrium but not extending into the uterine cavity or serous surface
Intramural	4	Intramural fibroid without contact with the endome-trium and without extension into the uterine cavity or serous surface
Subserosal	5	Subserosal fibroid with intramural extension > 50% and < 50% subserosal
	6	Subserosal fibroid with intramural extension < 50% and > 50% subserosal
	7	Subserosal pedunculated fibroid
Other	8	Other types of fibroids (e.g., cervical, broad ligament, and parasitic fibroids)
Hybrid type	2-5	Hybrid classification used when a fibroid extends from the endometrial cavity to the serosa, composed of two numbers, separated by a hyphen, the first characterizing the relationship between the fibroid and the endometrium and the second characterizing its relationship with the serosa

Parameter	Criteria
Uterus	Measurement of length, anteroposterior diameter, transverse diameter, and volume
Serosal contour	Regular or lobulated
Myometrial walls	Symmetrical or asymmetrical
Myometrial echogenicity	Homogeneous or heterogeneous
Myometrial lesions	Margins — Well-defined or ill-defined
	Number of lesions
	Location — Anterior , posterior, fundal, right/ left lateral, or global
	Type — According to the FIGO classification
	Size — Three perpendicular diameters
	Outer lesion-free margin — Distance from the serosal surface
	Inner lesion-free margin — Distance from the endometrial surface
	Echogenicity — Hypoechoic, isoechoic, or hy-perechoic

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[1] Correspondence: Dr. Michel Santos Palheta. Clínica Michel Palheta. Avenida Dom José Tupinambá da Frota, 2020, Centro. Sobral, CE, Brazil, 62010-290. Email: drpalheta@hotmail.com.