Fibroids are abnormal growths in or on a woman’s uterus. By the age of 50 years, about 80% of black women and 70% of white women have fibroids. Symptoms can include heavy menstrual bleeding, lower abdominal pain during menstruation, pelvic pain and pressure, increased urgency and frequency of urination, and constipation. Symptoms usually are the worst in the years before menopause and subside afterward.
For women who are suspected to have fibroids, duplex Doppler ultrasound of the pelvis, transabdominal ultrasound of the pelvis, and transvaginal ultrasound of the pelvis are usually appropriate. These are complementary tests, and more than one is ordered at the same time. MRI of the pelvis without and with intravenous (IV) contrast and MRI of the pelvis without IV contrast may be appropriate.
For women with known fibroids who are planning treatment, duplex Doppler ultrasound of the pelvis, transabdominal ultrasound of the pelvis, transvaginal ultrasound of the pelvis, and MRI of the pelvis without and with IV contrast are usually appropriate. These are complementary tests. MRI of the pelvis without IV contrast may be appropriate.
For women with known fibroids who are in the posttreatment or surveillance stage, duplex Doppler ultrasound of the pelvis, transabdominal ultrasound of the pelvis, transvaginal ultrasound of the pelvis, and MRI of the pelvis without and with IV contrast are usually appropriate. These are complementary tests. MRI of the pelvis without IV contrast and CT of the pelvis with IV contrast may be appropriate.