Contribution of MRI in the management of uterine fibroids

Management of uterine leiomyoma greatly depends upon the precision of the initial diagnosis. Due to the increasing demand of uterine conserving surgery, surgical treatment options have become more complex. Results of pre-treatment ultrasound of the pelvis can be insufficient in patients with large uteri, multiple leiomyoma, and doubts about the uterine versus ovarian origin of a mass or about the nature of the uterine mass (adenomyoma versus leiomyoma). This article describes magnetic resonance imaging techniques of the female pelvis and diagnostic criteria to answer unresolved problems by ultrasound. Important points of uterine mapping are explained. New findings concerning the predictive value of MRI for the medical treatment of leiomyoma or for uterine embolization are discussed. The aspect of MRI in uterine sarcoma and intravenous leiomyomatosis are presented.