ABSTRACT
The purpose of this chapter is to review the application of magnetic resonance imaging (MRI) in preoperative imaging of uterine leiomyomas. MRI is the most accurate imaging modality for the detection and localization of uterine leiomyomas due to its superior tissue contrast resolution compared to ultrasound. MRI preoperative mapping can provide important information regarding the number and size of uterine leiomyomas, and their location relative to the endometrium and outer uterus contour. Leiomyomas classically appear as well-circumscribed masses that are T2 hypointense relative to the outer myometrium and demonstrate variable degrees of contrast enhancement. They can occasionally undergo degeneration and present with atypical imaging features. MRI is helpful in confirming the diagnosis of leiomyomas and in diagnosing any coexisting uterine or adnexal pathology. The 2011 classification system of the International Federation of Gynecology and Obstetrics provides specific criteria for classification of uterine leiomyomas, which improves interobserver consistency and provides important information in selecting the most appropriate management strategy. MRI features may also be helpful in predicting treatment success and in assessing the risk of potential treatment-related complications.
