The estimated volume of the fibroid uterus: a comparison of ultrasound and bimanual examination versus volume at MRI or hysterectomy

Stoelinga, B.; Huirne, Judith A.F.; Heymans, Martijn W.; Reekers, Jim A.; Ankum, Willem M.; Hehenkamp, Wouter J.K.

doi:10.1016/j.ejogrb.2014.11.011

Cited by 11 publications

(4 citation statements)

References 30 publications

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“…In the present study, uterine volume was significantly higher in MRI than in US. This result was also observed by Stoelinga et al [13], who assessed 83 women who underwent uterine-artery embolization because of fibroids, and observed a mean uterine volume 557 cm 3 in MRI and 472 cm 3 in US. Likewise, Rajan et al [9] observed a mean volume of 701 cm 3 in MRI and 658 cm 3 in US.…”

Section: Discussionsupporting

confidence: 73%

Impact of pelvic magnetic resonance imaging findings in the indication of uterine artery embolization in the treatment of myoma

et al. 2017

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Objectives: To assess the impact of pelvic magnetic resonance imaging (MRI) findings in the indication for uterine-artery embolization in women with fibroids, as well as the correlation between MRI and ultrasound (US) examinations for diagnosing adenomyosis. Material and methods:A retrospective observational study was performed through the analysis of the medical records of 263 women referred for uterine-artery embolization as treatment for fibroids after undergoing US and MRI examinations. To compare uterine volume and fibroid measurement in US and MRI, the Wilcoxon test was used; for the number of fibroids, the McNemar test was used. The kappa coefficient was used to evaluate the correlation between US and MRI findings for diagnosing adenomyosis. Results:The mean age of patients was 37.9 ± 6.8 years and 191 (72.6%) were nulliparous. Forty-three patients with adenomyosis associated with fibroid were diagnosed by MRI; US indicated the presence of adenomyosis in 12 (4.56%) women. There was agreement between MRI and US in the diagnosis of adenomyosis in 218/263 (82.9%) patients (p < 0.05). In the US examination, the mean uterine volume was lower (389 ± 340.8 cm³) than that observed in MRI (472.2 ± 415.9 cm³; p < 0.001). Regarding the number of fibroids, MRI showed a greater number of patients with multiple fibroids (68.8% vs. 57.4%, MRI and US, respectively; p < 0.001). Conclusions:In women with fibroids referred for uterine-artery embolization, MRI findings led to the revision of the initial diagnosis in 17.1% cases. US showed a lower sensitivity for diagnosing adenomyosis than MRI.

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Section: Discussionsupporting

confidence: 73%

Impact of pelvic magnetic resonance imaging findings in the indication of uterine artery embolization in the treatment of myoma

et al. 2017

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“…Uterine measurements were based on its length (which also included the uterine cervix), as well as the largest diameters in the anteroposterior and transverse axes measured in several sequences of the MRI examination (Figure 1). 17,18 Fibroid measurements were based on their largest diameter (Figure 2) and the other 2 largest measures taken in planes orthogonal to the first one. Finally, the volumes of both the leiomyomas and the uterus were calculated using the formula to calculate the volume of an ellipse (volume ¼ p � (d1 � d2 � d3)/6)).…”

Section: Assessed Featuresmentioning

confidence: 99%

Reproducibility of MRI Features of Uterine Leiomyomas: A Study on Interobserver Agreement and Inter-Method Agreement With Surgery

et al. 2021

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Purpose: To evaluate interobserver agreement in the interpretation of different MRI features of uterine leiomyomas (UL) according to observers’ experience, and to assess the inter-method reproducibility (MRI versus surgery) regarding the International Federation of Gynecology and Obstetrics (FIGO) classification. Methods: Retrospective study including UL patients who underwent MRI and surgical treatment. Four blinded observers (2 vs >10 years of experience) assessed UL regarding dimensions and volume; inner and outer mantles; FIGO classification; vascularization; degeneration; and diffusion-weighted imaging features. Uterine dimensions and volume were calculated. FIGO classification as ascertained by observers was compared to surgical findings. Intraclass correlation coefficient (ICC) estimates were used for interobserver comparison of numerical variables, and kappa statistic for categorical variables. Results: Thirty-five patients (26y-73y) with 61 UL were included in the interobserver analyses, and 31 patients (54 UL) had available data allowing retrospective surgical FIGO classification for assessment of inter-method reproducibility. Both groups of observers had good to excellent agreement in assessing UL (ICC = 0.980-0.994) and uterine volumes (ICC = 0.857-0.914), mantles measurement (ICC = 0.797-0.920), and apparent diffusion coefficient calculation (ICC = 0.787-0.883). There was substantial agreement for both groups regarding FIGO classification (κ = 0.645-0.767). Vascularization, degeneration and restricted diffusion had lower agreement, varying from reasonable to moderate. Inter-method agreement was reasonable (κ = 0.341-0.395). Conclusions: Interobserver agreement of MRI for UL was higher for quantitative than qualitative features, with a little impact of observers’ experience for most features. MRI agreement with surgery was reasonable. Further efforts should be taken to improve interobserver and inter-method reproducibility for MRI in this scenario.

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“…Bimanual vaginal examination (BVE) is an essential clinical skill and key for the diagnosis of various gynecological pathologies . Despite its importance, medical students report a lack of experience, training, and confidence in performing the procedure .…”

Section: Introductionmentioning

confidence: 99%

Standardizing bimanual vaginal examination using cognitive task analysis

Plumptre

Mulki

Granados

et al. 2017

Intl J Gynecology & Obste

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The estimated volume of the fibroid uterus: a comparison of ultrasound and bimanual examination versus volume at MRI or hysterectomy

Cited by 11 publications

References 30 publications

Impact of pelvic magnetic resonance imaging findings in the indication of uterine artery embolization in the treatment of myoma

Impact of pelvic magnetic resonance imaging findings in the indication of uterine artery embolization in the treatment of myoma

Reproducibility of MRI Features of Uterine Leiomyomas: A Study on Interobserver Agreement and Inter-Method Agreement With Surgery

Standardizing bimanual vaginal examination using cognitive task analysis

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