Imaging techniques for evaluation of uterine myomas

- Ultrasound can be considered as the first diagnostic tool in the evaluation of uterine fibromatosis.
- Magnetic resonance imaging can be considered as a secondary technique for evaluation of uterine fibromatosis, though more accurate than ultrasound.
- The identification of imaging parameters able to differentiate benign from malignant myometrial pathology are still required.

Due to their high prevalence and related morbidity, uterine myomas constitute a group of gynecological pathologies largely studied in all clinical, diagnostic, and therapeutic aspects. They have been widely evaluated with a large series of imaging techniques. In fact, ultrasound (also saline infusion sonohysterography) and magnetic resonance imaging (MRI) are considered the optimal methods to assess uterine fibroids in terms of number, volume, echostructure, location, relation with endometrial cavity and uterine layers, vascularization, and differential diagnosis with other benign (adenomyosis) and malignant myometrial pathologies. Nevertheless, further studies are required to fill some gaps such as the absence of a common and sharable sonographic terminology and methodology to scan the myometrium, as well as imaging parameters for differentiation of typical myomas from smooth tumors of unknown malignant potential (STUMP) and leiomyosarcomas.