Vascularity of uterine myomas: Assessment by color and pulsed Doppler ultrasound

Objective: To evaluate the effects of different clinical and anatomical factors on the vascularity of uterine myomas. Methods: The study group included 195 patients, 153 premenopausal and 42 postmenopausal. Four hundred five myomas, 316 in the first group and 89 in the second, were studied by color Doppler ultrasound. Differences in the visualization of blood flow and resistance index (RI) were analyzed according to several factors, including: menopausal status, phase of menstrual cycle, duration of menopause, size and location of the myomas, and secondary changes within the myomas. Results: The size of myomas was the most important single factor in determining both visualization of blood flow and RI. A higher blood flow visualization rate (BFVR) and a lower RI were found: (1) in the premenopausal compared with the postmenopausal patients (P < 0.05), (2) in the group of larger myomas compared with the group of smaller myomas (P < 0.0001), and (3) in submucosal and subserosal myomas compared with intramural myomas (P < 0.05). Other above-mentioned factors did have some, but not significant, influence on the visualization of blood flow and resistance to blood flow. Conclusion: Differences in the vascularity and resistance to blood flow in uterine myomas may limit the clinical use of color Doppler ultrasound.