Color Flow Imaging of Leiomyomas and Focal Myometrial Contractions During Pregnancy

Abstract

In a prospective study, 15 pregnant patients with a total of 7 leiomyomas and 10 focal myometrial contractions were evaluated with color flow imaging. Images were graded based on vascularity. Leiomyomas were grade III (hypervascular) in 85.7% and grade II (peripheral flow only) in 14.3% of cases. Contractions were grade I (hypovascular) in 80% and grade II in 20% of cases. Contractions involving the placenta demonstrated vascularity adjacent to the myometrium at the placentation site. Color flow imaging is useful when used in conjunction with two-dimensional findings to differentiate between leiomyomas and focal myometrial contractions during pregnancy.Leiomyomas are the most common solid uterine mass found during pregnancy, occurring in 0.3% to 2.6% of all pregnancies. I Only 40% of leiomyomas diagnosed sonographically during pregnancy, however, are clinically detected. 2 On ultrasound, leiomyomas may be mistaken for ovarian tumors, the cornua of a bicornuate uterus, or focal myometrial contractions.3 It is especially difficult to differentiate between leiomyomas of less than 3 cm and focal myometrial contractions. The ultrasound differentiation of leiomyomas from focal myometrial contractions is usually based on two-dimensional characteristics. To date, a comparison of color flow characteristics of leiomyomas and focal myometrial contractions has not been discussed. This study compares and contrasts the color flow characteristics of leiomyomas and focal myometrial contractions and discusses the diagnostic implications of the findings. Materials and MethodsColor flow imaging was used to examine 15 patients with a total of 7 leiomyomas and 10 contractions (two patients had both a leiomyoma and a contraction). Of the 15 patients, 3 were in the first trimester of pregnancy (20%), 9 were in the second