Uterine Fibroids

Diagnosis

Uterine fibroids are sometimes detected incidentally on an X-ray or CT scan taken for other purposes. But they're usually diagnosed using a combination of hands-on skills and high-tech imaging tests.

Pelvic Exam After asking a patient about her symptoms and family health history, Mayo gynecologists conduct a pelvic exam to evaluate the position, size and shape of her uterus. If it's enlarged, or its contour is bumpy, the doctor will probably suspect fibroids. Further tests will be ordered to rule out other disorders -- such as endometrial polyps and uterine malignancies -- that can produce similar symptoms.

Endometrial Biopsy When women complain of abnormal bleeding, Mayo gynecologists often perform an endometrial biopsy, scraping a cell sample from the lining of the uterus for laboratory analysis. While endometrial biopsies, like PAP smears, aren't useful in testing for fibroids, they can verify that symptoms aren't caused by other disorders such as uterine cancer. Since this procedure doesn't require anesthesia, it can be done in the physician's office in conjunction with the pelvic exam.

Complete Blood Count (CBC) Mayo gynecologists routinely evaluate the blood's cellular components in women with heavy or prolonged menstrual bleeding. A CBC tells the physician if a patient has iron deficiency anemia, the result of chronic blood loss, a common by-product of fibroids. Women with iron deficiency anemia require treament with iron supplements, in addition to treatment for their uterine fibroids.

Ultrasound Scanning Relying on high-frequency sound waves to produce pictures of the uterus, ultrasound or sonography is often the initial imaging screen used to verify fibroids. A handheld device (transducer) beams sound waves through the abdominal wall (transabdominal) and vagina (transvaginal) into the uterus. As the waves slice through tissue, they send back echoes processed by a computer into pictures displayed on its screen. Ultrasound offers Mayo clinicians a quick and painless way to chart fibroids.

Hysteroscopy This office procedure allows physicians to visually examine the inner walls of uterus and also take an endometrial tissue sample. Inserted through the vagina and cervix, the thin, telescopic tube of the hysteroscope contains fiber optics to illuminate the uterus and a tiny cutting tool to take a sample. Mayo doctors frequently order hysteroscopies when they want to see if a woman's abnormal bleeding is something other than a fibroid.

Magnetic Resonance Imaging (MRI) MRI is used when a Mayo physician wants to fine-tune information about the number, size and precise location of uterine fibroids. MRI scanning is useful for evaluating fibroid characteristics such as blood flow, cellularity, and areas of cell death (necrosis). Mayo researchers hope that in the future, features from MRI scans will help with earlier diagnosis of rare malignancies that can mimic a uterine fibroid.