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UCLA Radiology Fibroid Imaging and Treatment Program


How do I know for sure that I have fibroids?

Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina and for an annual cervical PAP smear. The doctor may be able to feel the fibroid with his or her hands during an ordinary pelvic exam, as a (usually painless) firm lump on the uterus. For medium and larger fibroids, your doctor will describe the size of your fibroids by comparing them to different stages of pregnancy. For example, you may be told that the size of your fibroids is similar in size to a uterus carrying a 20-week pregnancy (at the level of the belly button). Or the fibroid might be compared to fruit such as lemons, oranges or grapefruit to demonstrate a comparative size.

One of several imaging test generally confirms the size, position, and dynamic of Fibroids. The two most common modalities include Ultrasound and Magnetic Resonance Imaging (MRI):

  • Ultrasound

    Using sound waves with frequencies (pitch) much higher than audible sound, ultrasound is the most commonly used type of scan for pelvic evaluation. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to help scan the uterus and ovaries. It is quick and simple and generally accurate. However it relies on the experience and skill of the person performing the scan to produce good results and may not always demonstrate larger fibroids or other conditions such as adenomyosis.

  • Magnetic Resonance Imaging (MRI)

    MRI uses magnets and radio waves to produce the picture. It is considered the single best test for the uterus and can exactly demonstrate the number and location of fibroids as well as distinguish adenomyosis from fibroids. We rely primarily on MRI to triage patients to therapy.

  • Hysterosalpingogram (HSG)

    An HSG is usually used in women with trouble conceiving a baby to demonstrate the anatomy of the inside of the uterus (uterine cavity) and fallopian tubes. It does not evaluate the size of the uterus or uterine wall reliably. After a small catheter tube is placed in the uterus, x-ray dye is slowly injected via the catheter into the uterus and x-ray pictures are taken.

  • Hysterosonogram

    A hysterosonogram is used to see the inside of the uterus (uterine cavity) with ultrasound and injected fluid. After a small catheter tube is placed inside the uterus, water is injected while a series of ultrasound images are taken. This test can confirm the presence of uterine polyps or intracavitary fibroids that can cause heavy bleeding.

If these tests don't adequately determine the source of your pelvic pain, you might also need surgery. The least invasive surgeries for diagnosis is know as laparoscopy.

  • Laparoscopy

    During laparoscopy, through tiny incision made in or near the navel, a long, thin scope is inserted into the abdomen and pelvis. The scope has a bright light and a camera and allows your doctor to see the uterus and surrounding structures to determine if you have conditions such as endometriosis, which can cause pelvic pain.

  • Hysteroscopy

    For suspected abnormalities inside the uterine cavity, a long, thin scope with camera and light is passed through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for cavitary fibroids or endometrial polyps.