Imaging leiomyomas prior to endoscopic surgery: the role of magnetic resonance imaging

Objective To determine whether the use of scanning by magnetic resonance imaging (MRI) prior to endoscopic surgery for uterine fibroids gave an improved outcome compared with the use of ultrasound. Design A retrospective analysis of the available literature, Results The improved imaging afforded by MRI results In a better differentiation of fibroids from focal adenomyomas, and more accurate assessment of the size, number and location of fibroids within the uterus, when compared with the results obtained, by ultrasound scanning. Conclusions In situations such as infertility where uterine conservation is paramount, the extra information provided by MRI allows better preoperative counselling and planning, and should be considered as an alternative to ultrasound scanning. However, it should not be considered as a first-line investigation when patients are undergoing hysterectomy or when the diagnosis is thought to be diffuse adenomyosis.