Maria Luisa C. Fogata MD. Having fibroids at a much younger age may be related to a strong family history and the increased risk of uterine leiomyoma in people of African descent. 4.9), appears to be unrelated to the clinical symptoms . Free Access. Keywords: Fibroid, Hyaline degeneration, Leiom yoma of the uterus, ... A 51-year-old woman was referred with a large adnexal mass that appeared on ultrasound to be a simple ovarian cyst. The average number of fibroid nodules and diameter were estimated as, 3.3 and 2.7 cm respectively. Article  Radiography. 3D and 3E). 1994;83:549–55. In non –pregnant it may appear so massive with features suggestive of … 2006;10:1. It is observed that fibroid sizes less than 3 cm were 47.4, 22.3 and 25.0 % prevalence among women below 35 years, 35–44 years, and 45 and above years respectively. CAS  In premenopausal women, larger fibroid sizes are expected. Masters C. Are hysterectomies too common? Precise knowledge of the histopathologic backgrounds of degeneration and the clinical course helps u… The finding is consistent with available data [19] which suggest that fibroids are the most common pelvic tumour in women, causing symptoms in approximately 25 % of reproductive age women with the overall prevalence of fibroids increasing to over 70 %. 2000;12:1–8. 2005;48:258–73. It observed that the difference in the findings could be that the current study did not limit the females to those above 20 years as done by Ofori et al. Magnetic resonance-guided focused ultrasound surgery. Data was also summarized using tables, bar charts, pie and charts. The centres were chosen because they had identical scanning equipment models and large patient turn over. Hysterectomy in the United States, 1988–1990. Agency for Healthcare Research and Quality (AHRQ): Summary, Evidence Report/Technology Assessment. Obset Gynecol. This suggests that uterine fibroid detection by sonography is very common among women in their late 30’s and 40’s and usually shrink after menopause. In the study site, people below 18 years are considered minors. Different forms of fibroid degeneration can also occur: Hyaline degeneration is the most common, whereby smooth muscle is replaced by fibroid connective tissue. Focused ultrasound surgery (FUS) is a noninvasive treatment option for uterine fibroids — noncancerous growths of the uterus. 3 In general, these areas of cystic degeneration are irregular and can appear as a combination of cystic and solid components of variable echogenicity. Evans P, Brunsel S. Uterine fibroid tumors: diagnosis and treatment. Fibroids create child bearingand marital problems relating to intercourse due to frequent and excessive bleeding, blood changes associated with menstrual cramps and heavy bleeds and therefore a health condition that requires attention. Intra-mural fibroids located entirely within the uterine wall are noted to be the most common variety [6]. Viswanathan M, Hartmann K, McKoy N, et al. Hatasaka H. Evaluation of abnormal uterine bleeding. Springer Nature. Cancer Cytogenet. Ultrasound examination of uterine fibroid among Ghanaian females in three major diagnostic centers indicated varying sonographic patterns however, the most popular echo pattern of the various fibroid nodules was mixed echogenicity and this pattern was predominant in females under 35 years and above. Systematic review: the value of the periodic health evaluation. The findings may aid in appropriate diagnosis and interventions in the country. Uterine fibroid embolization. The age range, mean and standard deviation (SD) of patients were 14–54 years, 31.9 years and ± 7.9 respectively. It happens when fibroid grows beyond its limited blood supply. Approval was also sought from the Medical Directorate of the selected centres. In our study, a specialist radiologist with 10 years experience undertook the scans post requisitions; therefore our findings are very credible. Degeneration, involving cell death, occurs inside the fibroid, and calcification, where calcium is deposited in the fibroid tissue, may be seen on an ultrasound scan. 2007;146:289–300. Google ScholarÂ. Fibroid sizes between 3 and 4.9 cm were also 26.3 % prevalent in women below 35 years, 33.3 % in women between 35 and 55 years, and 37.5 % in women at 45 and above years. Hai-Yun W, Yang L-L, Zhou S. Impact of periodic health examination on surgical treatment foruterine fibroids in Beijing: a case control study. Author BDS designed the study, performed the statistical analysis, wrote the protocol, and wrote the first draft of the manuscript. Leiomyomas of the urterus (or uterine fibroids) are benign tumors. Myomectomy in pregnancy is as yet reported in case series. Broder MS, Kanouse DE, Mittman BS, Bernstein SJ. Cystic degeneration of uterine leiomyomas, Cystic degeneration of a uterine leiomyoma. AHRQ Publication No. Fibroids appear on ultrasound in various echo patterns namely hypo-echoic, iso-echoic, hyper-echoic and mixed echo pattern [7]. A test of association between age of respondents and fibroid nodules size revealed a significant correlation between age and diameter of largest nodules (r = 0.209; p = 0.012) and number of nodules (r = 0.208; p = 0.012). [Accessed 4th Jul 2012]. The recorded situation in Ghana is worrying in view of health and other risk implications. http://www.time.com/time/health/article/0,8599,1644050,00.html?cnn=yes, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12905-016-0288-4, Gynecology, gynecological disease, and reproductive health. Clin Obstet Gynaecol. Obstet Gynecol. stimulated by estrogens). Degenerating Cystic Uterine Fibroid Mimics an Ovarian Cyst in a Pregnant Patient. Therefore parental consent was obtained for those below 18 years. The pedunculated type which recorded 7.7 % of all the fibroid cases was noted to be attached to the uterus by a stalk and usually grew bigger into the abdomen [26]. A month was allocated for each diagnostic centre and all patients who were referred to these three major diagnostic centres between the study period, to undertake abdominal-pelvic or pelvic ultrasound examinations were informed and recruited for the study. The sonographic patterns of uterine fibroids in terms of classification and location in the uterus are represented in Tables 5, 6 and 7. as well as in assessing disease in patients in whom ultrasound findings are. Extremely prevalent, they occur in more than 20% of women older than 30 years (,1,,2). The most popular (55.6 %) echo pattern of the various fibroid nodules was mixed echogenicity. Correspondence to 2005;25:42–4. Available at: [http://www.time.com/time/health/article/0,8599,1644050,00.html?cnn=yes. Fibroids are responsive to hormones (e.g. However, during the study, only 71.1 % (64/86) of them were confirmed of having fibroids. Table 2 illustrates cross tabulation of participant’s previous diagnosis of fibroids prior to the study against participants confirmed diagnosis of fibroids during the study. The purpose of this study was to identify the uterine fibroid characteristics and sonographic patterns of uterine fibroids among Ghanaian women undergoing abdomino-pelvic or pelvic ultrasound scan at three major diagnostic centres. Oct 8, 2017. However, during the study, only 71.1 % of that number were confirmed of having fibroids. Significant correlation was found between age and diameter of largest nodules (r = 0.209; p = 0.012) and number of nodules (r = 0.208; p = 0.012). By using this website, you agree to our Engel-Hills P. Radiation protection in medical imaging. The process of degeneration usually occurs when the fibroid grows so large that the blood vessels “feeding” the fibroid can no … Chi-square was used to assess age of respondents and their fibroid characteristics. 2012;4:67–78. Uterine fibroids can undergo hyaline, cystic, myxoid, and red degeneration. The range, mean and standard deviation (SD) of the patients’ ages were 14–54 years, 31.89 years and ± 7.92 respectively. University of Ghana School of Medicine and Dentistry, P. O. Descriptive statistics such as means, standard deviations, frequencies, percentages and proportions were calculated. 1991;21:1–3. 2004;8:1–157. Although the etiology of fibroids remains unknown, the female hormones estrogen and progesterone are hypothesized to enhance fibroid [12, 13]. Hormonal changes could account for this finding. On ultrasound, a typical leiomyoma usually has a whorled appearance, with variable echogenicity depending on the extent of degeneration, fibrosis, and calcification. Article  Hyaline degeneration usually appears as low signal on T2-weighted images (even lower than in usual fibroids, but the difference can be difficult to discern), although a heterogeneous pattern of distinct low signal intensity with a speckled appearance has been reported (Figure 38-3). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 01-E051. Sub-serosal fibroids recorded the second highest frequency (25.9 %) location. These patients included females who were 15 years old and over; however, excluded were patients with history of hysterectomy. PubMed  Fibroid has social, economic and medical implications in the female populace. Marshall LM, Spiegelman D, Manson JE, et al. In accordance with ethical requirement, ethical clearance was first sought and obtained from the Ethics committee of Ghana Medical School, College of Health Sciences, University of Ghana. The study took place in three major diagnostic centres in Ghana. ** Hyaline Degeneration. Degeneration is described as hyaline, myxomatous, calcific, cystic, fatty, red (usually only during ... saline is instilled into the uterus, enabling the sonographer to more specifically locate the fibroid in the uterus. 2007. HTA Monograph. Radiographic features Ultrasound. Prior to the study, 35.2 % (86/244) of the participants stated that they had been previously diagnosed to have fibroids. Lurie S, Piper I, Woliovitch I, GleZeman M. Age related prevalence of sonographically confirmed uterine myoma. Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. The use of ultrasound to diagnose and monitor the growth of fibroid [7] has been well accepted. Fibroids with this type of degeneration may show cystic areas with portions of … Available at: www.obgyn.net/displayarticle.asp. 2005;78:130–4. Ultrasound scanning machines at the selected sites were used in the study. This decision was taken in order to get (i) their individual consent and (ii) to encourage them to participate voluntarily and encourage co-operation. 2007. Sagba F. Uterine Leiomyoma: Urogenital, Obstetrics and Gynecology. It is the most common benign gynecologic tumor affecting premenopausal women [1, 2] which may be associated with considerable hospitalization and morbidity [3, 4]. Prior to the study, 35.2 % of the sampled participant’s stated that they had been previously diagnosed to have fibroids. Environ Health Perspect. Ofori EK, Antwi WK, Arthur EA, Brakohiapa EK, Sarkodie BD, Dzefi-Tettey K, et al. PubMed Central  MRI. BMC Women's Health Transvaginal ultrasound (TVS) is the initial imaging study of choice. PubMed  The current study also showed that 40.0 % women aged between 35 and 44 years also recorded significant cases of fibroid which is in agreement with previous work conducted elsewhere [19, 20]. Changes in rates of hysterectomy and uterine conserving procedures for treatment of uterine leiomyoma. 2009;361:690–7. That is, the diagnostic competence of the referring physician and the sonographer/radiologists. In general the prevalence or confirmed rate of the participants having fibroid was 36.9 % (90/244). BMC Women's Health 16, 10 (2016). ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Furthermore, the type of degenerative transformation seems to depend on the degree and rapidity of … Tone and Tighten Recommended for you Hyaline cystic degenerations of the uterine fibroids may be rare but not uncommon. Saunders M, Budden A, Maclver F. Dose implications of fluoroscopy-guided positioning (FGP) for lumbar spine examinations prior to acquiring plain film radiographs. Fibroid degeneration takes place when the fibroid has been increasing in size over a number of years, and its blood supply is no longer adequate to support the center of the tumor. This finding was in aberrant with a previous study [28] which found hypo echoic pattern as the most common (79 %) echo pattern noted in diagnosed fibroid nodules using sonography. Hyaline degeneration is the most common type of fibroids degeneration that can occur in 60% of all fibroids cases. Indian J Radiol Imaging. The sonographic patterns of uterine fibroids among Ghanaian women have been assessed at three major diagnostic centres. In Ghana, information on the ultrasonography pattern of fibroids is essential for policy formulation. Variants of leiomyomas occur when they undergo cystic degeneration, hyalinization, or calcification. 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