Benign Uterine Lesions

  • Thomas J. KrönckeEmail author
Part of the Medical Radiology book series (MEDRAD)


Leiomyomas, or leiomyomas, are the most common benign tumors of the uterus. The incidence of leiomyomas is difficult to estimate and frequencies reported in the literature range between 25 and 50%. In autopsy studies, leiomyomas of the uterus have been found in up to 77% of women (ACOG 1994; Buttram and Reiter 1981; Cramer and Patel 1990). Only about one-third of affected women have leiomyomas that become clinically apparent before menopause. Leiomyomas may cause abnormal menstrual bleeding (menorrhagia with secondary anemia, dysmenorrhea, sensation of increased abdominal girth) or pelvic pressure due to their mass effect (urinary urgency, constipation, pelvic pain, dyspareunia). Finally, leiomyomas of the uterus are also implicated in female infertility and are the most common indication for hysterectomy in Western industrialized countries. In the USA, 430,000 hysterectomies were performed in 2010 most commonly for leiomyomas (40.7%) and endometriosis (17.7%) (Wright et al. 2013).


  1. Abbara S, Spies JB, Scialli AR, Jha RC, Lage JM, Nikolic B (1999) Transcervical expulsion of a fibroid as a result of uterine artery embolization for leiomyomata. J Vasc Interv Radiol 10(4):409–411PubMedGoogle Scholar
  2. ACOG (1994) Uterine leiomyomata. ACOG technical bulletin Number 192—May 1994. Int J Gynaecol Obstet 46(1):73–82Google Scholar
  3. ACOG (2001) ACOG practice bulletin. Surgical alternatives to hysterectomy in the management of leiomyomas. Number 16, May 2000 (replaces educational bulletin number 192, May 1994). Obstet Gynecol 73(3):285–293Google Scholar
  4. American College of Obstetricians and Gynecologists (2008) ACOG practice bulletin. Alternatives to hysterectomy in the management of leiomyomas. Obstet Gynecol 112(2 Pt 1):387–400Google Scholar
  5. Andersen PE, Lund N, Justesen P, Munk T, Elle B, Floridon C (2001) Uterine artery embolization of symptomatic uterine fibroids. Initial success and short-term results. Acta Radiol 42(2):234–238PubMedGoogle Scholar
  6. Andreyko JL, Blumenfeld Z, Marshall LA, Monroe SE, Hricak H, Jaffe RB (1988) Use of an agonistic analog of gonadotropin-releasing hormone (nafarelin) to treat leiomyomas: assessment by magnetic resonance imaging. Am J Obstet Gynecol 158(4):903–910PubMedGoogle Scholar
  7. Ascher SM, Arnold LL, Patt RH et al (1994) Adenomyosis: prospective comparison of MR imaging and transvaginal sonography. Radiology 190(3):803–806PubMedGoogle Scholar
  8. Ascher SM, O’Malley J, Semelka RC, Patt RH, Rajan S, Thomasson D (1999) T2-weighted MRI of the uterus: fast spin echo vs. breath-hold fast spin echo. J Magn Reson Imaging 9(3):384–390PubMedGoogle Scholar
  9. Athanasoulis CA, Waltman AC, Barnes AB, Herbst AL (1976) Angiographic control of pelvic bleeding from treated carcinoma of the cervix. Gynecol Oncol 4(2):144–150PubMedGoogle Scholar
  10. Azziz R (1989) Adenomyosis: current perspectives. Obstet Gynecol Clin N Am 16(1):221–235Google Scholar
  11. Battista C, Capriglione S, Guzzo F et al (2016) The challenge of preoperative identification of uterine myomas: is ultrasound trustworthy? A prospective cohort study. Arch Gynecol Obstet 293(6):1235–1241PubMedGoogle Scholar
  12. Bazot M, Cortez A, Darai E et al (2001) Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod 16(11):2427–2433PubMedGoogle Scholar
  13. Bell SW, Kempson RL, Hendrickson MR (1994) Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol 18(6):535–558PubMedGoogle Scholar
  14. Benson RC, Sneeden VD (1958) Adenomyosis: a reappraisal of symptomatology. Am J Obstet Gynecol 76(5):1044–1057; discussion 1057-1061PubMedGoogle Scholar
  15. Berkowitz RP, Hutchins FL Jr, Worthington-Kirsch RL (1999) Vaginal expulsion of submucosal fibroids after uterine artery embolization. A report of three cases. J Reprod Med 44(4):373–376PubMedGoogle Scholar
  16. Bird CC, McElin TW, Manalo-Estrella P (1972) The elusive adenomyosis of the uterus—revisited. Am J Obstet Gynecol 112(5):583–593PubMedGoogle Scholar
  17. Borah BJ, Nicholson WK, Bradley L, Stewart EA (2013) The impact of uterine leiomyomas: a national survey of affected women. Am J Obstet Gynecol 209(4):319 e311–319 e320Google Scholar
  18. Broder MS, Kanouse DE, Mittman BS, Bernstein SJ (2000) The appropriateness of recommendations for hysterectomy. Obstet Gynecol 95(2):199–205PubMedGoogle Scholar
  19. Broder MS, Goodwin S, Chen G et al (2002) Comparison of long-term outcomes of myomectomy and uterine artery embolization. Obstet Gynecol 100(5 Pt 1):864–868PubMedGoogle Scholar
  20. Brooks SE, Zhan M, Cote T, Baquet CR (2004) Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989-1999. Gynecol Oncol 93(1):204–208PubMedGoogle Scholar
  21. Brosens JJ, de Souza NM, Barker FG, Paraschos T, Winston RM (1995) Endovaginal ultrasonography in the diagnosis of adenomyosis uteri: identifying the predictive characteristics. Br J Obstet Gynaecol 102(6):471–474PubMedGoogle Scholar
  22. Brown BJ, Heaston DK, Poulson AM, Gabert HA, Mineau DE, Miller FJ Jr (1979) Uncontrollable postpartum bleeding: a new approach to hemostasis through angiographic arterial embolization. Obstet Gynecol 54(3):361–365PubMedGoogle Scholar
  23. de Bruijn AM, Smink M, Hehenkamp WJK et al (2017) Uterine artery embolization for symptomatic adenomyosis: 7-year clinical follow-up using UFS-Qol questionnaire. Cardiovasc Intervent Radiol 40(9):1344–1350PubMedPubMedCentralGoogle Scholar
  24. Brunereau L, Herbreteau D, Gallas S et al (2000) Uterine artery embolization in the primary treatment of uterine leiomyomas: technical features and prospective follow-up with clinical and sonographic examinations in 58 patients. AJR Am J Roentgenol 175(5):1267–1272PubMedGoogle Scholar
  25. Burn P, McCall J, Chinn R, Healy J (1999) Embolization of uterine fibroids. Br J Radiol 72(854):159–161PubMedGoogle Scholar
  26. Buttram VC Jr, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36(4):433–445PubMedGoogle Scholar
  27. Byun JY, Kim SE, Choi BG, Ko GY, Jung SE, Choi KH (1999) Diffuse and focal adenomyosis: MR imaging findings. Radiographics 19 Spec No:S161–170Google Scholar
  28. Candiani GB, Fedele L, Parazzini F, Villa L (1991) Risk of recurrence after myomectomy. Br J Obstet Gynaecol 98(4):385–389PubMedGoogle Scholar
  29. Casillas J, Joseph RC, Guerra JJ Jr (1990) CT appearance of uterine leiomyomas. Radiographics 10(6):999–1007PubMedGoogle Scholar
  30. Chiang CH, Chang MY, Hsu JJ et al (1999) Tumor vascular pattern and blood flow impedance in the differential diagnosis of leiomyoma and adenomyosis by color Doppler sonography. J Assist Reprod Genet 16(5):268–275PubMedPubMedCentralGoogle Scholar
  31. Chrisman HB, Saker MB, Ryu RK et al (2000) The impact of uterine fibroid embolization on resumption of menses and ovarian function. J Vasc Interv Radiol 11(6):699–703PubMedGoogle Scholar
  32. Colgan TJ, Pron G, Mocarski EJ, Bennett JD, Asch MR, Common A (2003) Pathologic features of uteri and leiomyomas following uterine artery embolization for leiomyomas. Am J Surg Pathol 27(2):167–177PubMedGoogle Scholar
  33. Connors AM, deSouza NM, McIndoe GA (2003) Adenomyoma mimicking an aggressive uterine neoplasm on MRI. Br J Radiol 76(901):66–68PubMedGoogle Scholar
  34. Coronado GD, Marshall LM, Schwartz SM (2000) Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study. Obstet Gynecol 95(5):764–769PubMedGoogle Scholar
  35. Cramer SF, Patel A (1990) The frequency of uterine leiomyomas. Am J Clin Pathol 94(4):435–438PubMedGoogle Scholar
  36. DeWaay DJ, Syrop CH, Nygaard IE, Davis WA, Van Voorhis BJ (2002) Natural history of uterine polyps and leiomyomata. Obstet Gynecol 100(1):3–7PubMedGoogle Scholar
  37. Donnez J, Tomaszewski J, Vazquez F et al (2012) Ulipristal acetate versus leuprolide acetate for uterine fibroids. N Engl J Med 366(5):421–432PubMedGoogle Scholar
  38. Donnez J, Vazquez F, Tomaszewski J et al (2014) Long-term treatment of uterine fibroids with ulipristal acetate. Fertil Steril 101(6):1565–1573 e1561-1518PubMedGoogle Scholar
  39. Donnez J, Hudecek R, Donnez O et al (2015) Efficacy and safety of repeated use of ulipristal acetate in uterine fibroids. Fertil Steril 103(2):519–527.e513PubMedGoogle Scholar
  40. Doridot V, Dubuisson JB, Chapron C, Fauconnier A, Babaki-Fard K (2001) Recurrence of leiomyomata after laparoscopic myomectomy. J Am Assoc Gynecol Laparosc 8(4):495–500PubMedGoogle Scholar
  41. Dubuisson JB, Fauconnier A, Chapron C, Kreiker G, Norgaard C (1998) Second look after laparoscopic myomectomy. Hum Reprod 13(8):2102–2106PubMedGoogle Scholar
  42. Dudiak CM, Turner DA, Patel SK, Archie JT, Silver B, Norusis M (1988) Uterine leiomyomas in the infertile patient: preoperative localization with MR imaging versus US and hysterosalpingography. Radiology 167(3):627–630PubMedGoogle Scholar
  43. Dueholm M, Lundorf E, Olesen F (2002a) Imaging techniques for evaluation of the uterine cavity and endometrium in premenopausal patients before minimally invasive surgery. Obstet Gynecol Surv 57(6):388–403PubMedGoogle Scholar
  44. Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F (2002b) Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol 186(3):409–415PubMedGoogle Scholar
  45. Dueholm M, Lundorf E, Sorensen JS, Ledertoug S, Olesen F, Laursen H (2002c) Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging. Hum Reprod 17(1):195–200PubMedGoogle Scholar
  46. Faerstein E, Szklo M, Rosenshein N (2001) Risk factors for uterine leiomyoma: a practice-based case-control study. I. African-American heritage, reproductive history, body size, and smoking. Am J Epidemiol 153(1):1–10PubMedGoogle Scholar
  47. Fauconnier A, Chapron C, Babaki-Fard K, Dubuisson JB (2000) Recurrence of leiomyomata after myomectomy. Hum Reprod Update 6(6):595–602PubMedGoogle Scholar
  48. Fedele L, Bianchi S, Dorta M, Arcaini L, Zanotti F, Carinelli S (1992) Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis. Fertil Steril 58(1):94–97PubMedGoogle Scholar
  49. Fedele L, Bianchi S, Raffaelli R, Portuese A, Dorta M (1997) Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device. Fertil Steril 68(3):426–429PubMedGoogle Scholar
  50. Ferenczy A (1998) Pathophysiology of adenomyosis. Hum Reprod Update 4(4):312–322PubMedGoogle Scholar
  51. Flake GP, Andersen J, Dixon D (2003) Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect 111(8):1037–1054PubMedPubMedCentralGoogle Scholar
  52. Friedman AJ, Rein MS, Pandian MR, Barbieri RL (1990) Fasting serum growth hormone and insulin-like growth factor-I and -II concentrations in women with leiomyomata uteri treated with leuprolide acetate or placebo. Fertil Steril 53(2):250–253PubMedGoogle Scholar
  53. Ghossain MA, Buy JN, Bazot M et al (1994) CT in adnexal torsion with emphasis on tubal findings: correlation with US. J Comput Assist Tomogr 18(4):619–625PubMedGoogle Scholar
  54. Gilks CB, Clement PB, Hart WR, Young RH (2000) Uterine adenomyomas excluding atypical polypoid adenomyomas and adenomyomas of endocervical type: a clinicopathologic study of 30 cases of an underemphasized lesion that may cause diagnostic problems with brief consideration of adenomyomas of other female genital tract sites. Int J Gynecol Pathol 19(3):195–205PubMedGoogle Scholar
  55. Goldberg J (2005) Uterine artery embolization for adenomyosis: looking at the glass half full. Radiology 236(3):1111–1112; author reply 1112PubMedGoogle Scholar
  56. Goldstein HM, Medellin H, Ben-Menachem Y, Wallace S (1975) Transcatheter arterial embolization in the management of bleeding in the cancer patient. Radiology 115(3):603–608PubMedGoogle Scholar
  57. Goto A, Takeuchi S, Sugimura K, Maruo T (2002) Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer 12(4):354–361PubMedGoogle Scholar
  58. Grasel RP, Outwater EK, Siegelman ES, Capuzzi D, Parker L, Hussain SM (2000) Endometrial polyps: MR imaging features and distinction from endometrial carcinoma. Radiology 214(1):47–52PubMedGoogle Scholar
  59. Greenberg MD, Kazamel TI (1995) Medical and socioeconomic impact of uterine fibroids. Obstet Gynecol Clin N Am 22(4):625–636Google Scholar
  60. Hamlin DJ, Pettersson H, Fitzsimmons J, Morgan LS (1985) MR imaging of uterine leiomyomas and their complications. J Comput Assist Tomogr 9(5):902–907PubMedGoogle Scholar
  61. Hanley KZ, Birdsong GG, Mosunjac MB (2017) Recent developments in surgical pathology of the uterine corpus. Arch Pathol Lab Med 141(4):528–541PubMedGoogle Scholar
  62. Hapangama DK, Bulmer JN (2016) Pathophysiology of heavy menstrual bleeding. Womens Health (Lond) 12(1):3–13Google Scholar
  63. Hasan F, Arumugam K, Sivanesaratnam V (1991) Uterine leiomyomata in pregnancy. Int J Gynaecol Obstet 34(1):45–48PubMedGoogle Scholar
  64. Hashimoto K, Azuma C, Kamiura S et al (1995) Clonal determination of uterine leiomyomas by analyzing differential inactivation of the X-chromosome-linked phosphoglycerokinase gene. Gynecol Obstet Investig 40(3):204–208Google Scholar
  65. Hasson HM, Rotman C, Rana N, Sistos F, Dmowski WP (1992) Laparoscopic myomectomy. Obstet Gynecol 80(5):884–888PubMedGoogle Scholar
  66. Hayasaka K, Tanaka Y, Fujii M, Himi K, Negishi N (2000) Intravenous leiomyomatosis. J Comput Assist Tomogr 24(1):83–85PubMedGoogle Scholar
  67. Hehenkamp WJ, Volkers NA, Donderwinkel PF et al (2005) Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial): peri- and postprocedural results from a randomized controlled trial. Am J Obstet Gynecol 193(5):1618–1629PubMedGoogle Scholar
  68. Higgins CB, Bookstein JJ, Davis GB, Galloway DC, Barr JW (1977) Therapeutic embolization for intractable chronic bleeding. Radiology 122(2):473–478PubMedGoogle Scholar
  69. Hirai M, Shibata K, Sagai H, Sekiya S, Goldberg BB (1995) Transvaginal pulsed and color Doppler sonography for the evaluation of adenomyosis. J Ultrasound Med 14(7):529–532PubMedGoogle Scholar
  70. Horta M, Cunha TM, Oliveira R, Magro P (2015) Hydropic leiomyoma of the uterus presenting as a giant abdominal mass. BMJ Case Rep.
  71. Hricak H, Finck S, Honda G, Goranson H (1992) MR imaging in the evaluation of benign uterine masses: value of gadopentetate dimeglumine-enhanced T1-weighted images. AJR Am J Roentgenol 158(5):1043–1050PubMedGoogle Scholar
  72. Hurst BS, Matthews ML, Marshburn PB (2005) Laparoscopic myomectomy for symptomatic uterine myomas. Fertil Steril 83(1):1–23PubMedGoogle Scholar
  73. Hutchins FL Jr, Worthington-Kirsch R (2000) Embolotherapy for myoma-induced menorrhagia. Obstet Gynecol Clin N Am 27(2):397–405Google Scholar
  74. Hutchins FL Jr, Worthington-Kirsch R, Berkowitz RP (1999) Selective uterine artery embolization as primary treatment for symptomatic leiomyomata uteri. J Am Assoc Gynecol Laparosc 6(3):279–284PubMedGoogle Scholar
  75. Imaoka I, Ascher SM, Sugimura K et al (2002) MR imaging of diffuse adenomyosis changes after GnRH analog therapy. J Magn Reson Imaging 15(3):285–290PubMedGoogle Scholar
  76. Iribarne C, Plaza J, De la Fuente P, Garrido C, Garzon A, Olaizola JI (1994) Intramyometrial cystic adenomyosis. J Clin Ultrasound 22(5):348–350PubMedGoogle Scholar
  77. Jacoby VL, Kohi MP, Poder L et al (2016) PROMISe trial: a pilot, randomized, placebo-controlled trial of magnetic resonance guided focused ultrasound for uterine fibroids. Fertil Steril 105(3):773–780PubMedGoogle Scholar
  78. Janus C, White M, Dottino P, Brodman M, Goodman H (1989) Uterine leiomyosarcoma—magnetic resonance imaging. Gynecol Oncol 32(1):79–81PubMedGoogle Scholar
  79. Jeong YY, Kang HK, Park JG, Choi HS (2003) CT features of uterine torsion. Eur Radiol 13(Suppl 4):L249–L250PubMedGoogle Scholar
  80. Jha RC, Ascher SM, Imaoka I, Spies JB (2000) Symptomatic fibroleiomyomata: MR imaging of the uterus before and after uterine arterial embolization. Radiology 217(1):228–235PubMedGoogle Scholar
  81. Jha RC, Takahama J, Imaoka I et al (2003) Adenomyosis: MRI of the uterus treated with uterine artery embolization. AJR Am J Roentgenol 181(3):851–856PubMedGoogle Scholar
  82. Jiang W, Shen Q, Chen M et al (2014) Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review. Steroids 86:69–78PubMedGoogle Scholar
  83. Jones MW, Norris HJ (1995) Clinicopathologic study of 28 uterine leiomyosarcomas with metastasis. Int J Gynecol Pathol 14(3):243–249PubMedGoogle Scholar
  84. Kakarla A, Ash AK (2005) Pregnancy after embolisation of a fibroid: emergency caesarean myomectomy. J Obstet Gynaecol 25(3):300–301PubMedGoogle Scholar
  85. Kang S, Turner DA, Foster GS, Rapoport MI, Spencer SA, Wang JZ (1996) Adenomyosis: specificity of 5 mm as the maximum normal uterine junctional zone thickness in MR images. AJR Am J Roentgenol 166(5):1145–1150PubMedGoogle Scholar
  86. Karcaaltincaba M, Sudakoff GS (2003) CT of a ruptured pyomyoma. AJR Am J Roentgenol 181(5):1375–1377PubMedGoogle Scholar
  87. Katsumori T, Nakajima K, Tokuhiro M (2001) Gadolinium-enhanced MR imaging in the evaluation of uterine fibroids treated with uterine artery embolization. AJR Am J Roentgenol 177(2):303–307PubMedGoogle Scholar
  88. Katsumori T, Nakajima K, Mihara T, Tokuhiro M (2002) Uterine artery embolization using gelatin sponge particles alone for symptomatic uterine fibroids: midterm results. AJR Am J Roentgenol 178(1):135–139PubMedGoogle Scholar
  89. Katsumori T, Nakajima K, Mihara T (2003) Is a large fibroid a high-risk factor for uterine artery embolization? AJR Am J Roentgenol 181(5):1309–1314PubMedGoogle Scholar
  90. Katsumori T, Akazawa K, Mihara T (2005) Uterine artery embolization for pedunculated subserosal fibroids. AJR Am J Roentgenol 184(2):399–402PubMedGoogle Scholar
  91. Kawaguchi K, Fujii S, Konishi I, Nanbu Y, Nonogaki H, Mori T (1989) Mitotic activity in uterine leiomyomas during the menstrual cycle. Am J Obstet Gynecol 160(3):637–641PubMedGoogle Scholar
  92. Kawakami S, Togashi K, Konishi I et al (1994) Red degeneration of uterine leiomyoma: MR appearance. J Comput Assist Tomogr 18(6):925–928PubMedGoogle Scholar
  93. Kawamura N, Ichimura T, Ito F et al (2002) Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma. Cancer 94(6):1713–1720PubMedGoogle Scholar
  94. Kido A, Togashi K, Koyama T, Yamaoka T, Fujiwara T, Fujii S (2003a) Diffusely enlarged uterus: evaluation with MR imaging. Radiographics 23(6):1423–1439PubMedGoogle Scholar
  95. Kido A, Monma C, Togashi K et al (2003b) Uterine arterial embolization for the treatment of diffuse leiomyomatosis. J Vasc Interv Radiol 14(5):643–647PubMedGoogle Scholar
  96. Kim JC, Kim SS, Park JY (2000) “Bridging vascular sign” in the MR diagnosis of exophytic uterine leiomyoma. J Comput Assist Tomogr 24(1):57–60PubMedGoogle Scholar
  97. Kim MD, Won JW, Lee DY, Ahn CS (2004) Uterine artery embolization for adenomyosis without fibroids. Clin Radiol 59(6):520–526PubMedGoogle Scholar
  98. Kim MD, Kim NK, Kim HJ, Lee MH (2005) Pregnancy following uterine artery embolization with polyvinyl alcohol particles for patients with uterine fibroid or adenomyosis. Cardiovasc Intervent Radiol 28(5):611–615PubMedGoogle Scholar
  99. Kitamura Y, Ascher SM, Cooper C et al (2005) Imaging manifestations of complications associated with uterine artery embolization. Radiographics 25(Suppl 1):S119–S132PubMedGoogle Scholar
  100. Kitamura Y, Allison SJ, Jha RC, Spies JB, Flick PA, Ascher SM (2006) MRI of adenomyosis: changes with uterine artery embolization. AJR Am J Roentgenol 186(3):855–864PubMedGoogle Scholar
  101. Klatsky PC, Tran ND, Caughey AB, Fujimoto VY (2008) Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstet Gynecol 198(4):357–366PubMedGoogle Scholar
  102. Koshiyama M, Suzuki A, Ozawa M et al (2002) Adenocarcinomas arising from uterine adenomyosis: a report of four cases. Int J Gynecol Pathol 21(3):239–245PubMedGoogle Scholar
  103. Koyama T, Togashi K, Konishi I et al (1999) MR imaging of endometrial stromal sarcoma: correlation with pathologic findings. AJR Am J Roentgenol 173(3):767–772PubMedGoogle Scholar
  104. Kroencke TJ, Gauruder-Burmester A, Enzweiler CN, Taupitz M, Hamm B (2003) Disintegration and stepwise expulsion of a large uterine leiomyoma with restoration of the uterine architecture after successful uterine fibroid embolization: case report. Hum Reprod 18(4):863–865PubMedGoogle Scholar
  105. Kroencke TJ, Scheurig C, Kluner C, Taupitz M, Schnorr J, Hamm B (2006) Contrast-enhanced magnetic resonance angiography to predict ovarian artery supply of uterine fibroids—initial experience. Radiology 241(1):181–189PubMedGoogle Scholar
  106. Kroencke TJ, Scheurig C, Poellinger A, Gronewold M, Hamm B (2010) Uterine artery embolization for leiomyomas: percentage of infarction predicts clinical outcome. Radiology 255(3):834–841PubMedGoogle Scholar
  107. Kroncke TJ, Gauruder-Burmester A, Gronewold M et al (2004) Technical success rate, peri-interventional complications and radiation exposure of the transarterial embolization for leiomyomas of the uterus. Rofo 176(4):580–589PubMedGoogle Scholar
  108. Kroncke TJ, Gauruder-Burmester A, Scheurig C et al (2005) Transarterial embolization for uterine fibroids: clinical success rate and results of magnetic resonance imaging. Rofo 177(1):89–98PubMedGoogle Scholar
  109. Kunz G, Beil D, Huppert P, Leyendecker G (2000) Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging. Hum Reprod 15(1):76–82PubMedGoogle Scholar
  110. Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyendecker G (2005) Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod 20(8):2309–2316PubMedGoogle Scholar
  111. Kuwashima Y, Uehara T, Kishi K et al (1994) Intramural adenocarcinoma of the uterus, arisen from adenomyosis uteri, showing unique histologic appearances. Report of two cases. Eur J Gynaecol Oncol 15(6):418–423PubMedGoogle Scholar
  112. Lakhman Y, Veeraraghavan H, Chaim J et al (2017) Differentiation of uterine leiomyosarcoma from atypical leiomyoma: diagnostic accuracy of qualitative MR imaging features and feasibility of texture analysis. Eur Radiol 27(7):2903–2915PubMedGoogle Scholar
  113. Lee JH, Jeong YK, Park JK, Hwang JC (2003) “Ovarian vascular pedicle” sign revealing organ of origin of a pelvic mass lesion on helical CT. AJR Am J Roentgenol 181(1):131–137PubMedGoogle Scholar
  114. Leibsohn S, d’Ablaing G, Mishell DR Jr, Schlaerth JB (1990) Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol 162(4):968–974. discussion 974–966PubMedGoogle Scholar
  115. Levy B, Mukherjee T, Hirschhorn K (2000) Molecular cytogenetic analysis of uterine leiomyoma and leiomyosarcoma by comparative genomic hybridization. Cancer Genet Cytogenet 121(1):1–8PubMedGoogle Scholar
  116. Leyendecker G, Bilgicyildirim A, Inacker M et al (2015) Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study. Arch Gynecol Obstet 291(4):917–932PubMedGoogle Scholar
  117. Li HM, Liu J, Qiang JW, Zhang H, Zhang GF, Ma F (2016) Diffusion-weighted imaging for differentiating uterine leiomyosarcoma from degenerated leiomyoma. J Comput Assist Tomogr 41(4):599–606Google Scholar
  118. Lin G, Yang LY, Huang YT et al (2016) Comparison of the diagnostic accuracy of contrast-enhanced MRI and diffusion-weighted MRI in the differentiation between uterine leiomyosarcoma/smooth muscle tumor with uncertain malignant potential and benign leiomyoma. J Magn Reson Imaging 43(2):333–342PubMedGoogle Scholar
  119. Lumsden MA, West CP, Hawkins RA, Bramley TA, Rumgay L, Baird DT (1989) The binding of steroids to myometrium and leiomyomata (fibroids) in women treated with the gonadotrophin-releasing hormone agonist Zoladex (ICI 118630). J Endocrinol 121(2):389–396PubMedGoogle Scholar
  120. Lurie S, Gorbacz S, Caspi B, Borenstein R (1991) Parasitic leiomyoma: a case report. Clin Exp Obstet Gynecol 18(1):7–8PubMedGoogle Scholar
  121. Malzoni M, Rotond M, Perone C et al (2003) Fertility after laparoscopic myomectomy of large uterine myomas: operative technique and preliminary results. Eur J Gynaecol Oncol 24(1):79–82PubMedGoogle Scholar
  122. Mara M, Fucikova Z, Maskova J, Kuzel D, Haakova L (2005) Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 126(2):226–233PubMedGoogle Scholar
  123. Margolies MN, Ring EJ, Waltman AC, Kerr WS Jr, Baum S (1972) Arteriography in the management of hemorrhage from pelvic fractures. N Engl J Med 287(7):317–321PubMedGoogle Scholar
  124. Mark AS, Hricak H, Heinrichs LW et al (1987) Adenomyosis and leiomyoma: differential diagnosis with MR imaging. Radiology 163(2):527–529PubMedGoogle Scholar
  125. Marshall LM, Spiegelman D, Barbieri RL et al (1997) Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol 90(6):967–973PubMedGoogle Scholar
  126. Mas A, Cervello I, Gil-Sanchis C et al (2012) Identification and characterization of the human leiomyoma side population as putative tumor-initiating cells. Fertil Steril 98(3):741–751. e746PubMedGoogle Scholar
  127. Masui T, Katayama M, Kobayashi S, Sakahara H, Ito T, Nozaki A (2001) T2-weighted MRI of the female pelvis: comparison of breath-hold fast-recovery fast spin-echo and nonbreath-hold fast spin-echo sequences. J Magn Reson Imaging 13(6):930–937PubMedGoogle Scholar
  128. Masui T, Katayama M, Kobayashi S, Shimizu S, Nozaki A, Sakahara H (2003) Pseudolesions related to uterine contraction: characterization with multiphase-multisection T2-weighted MR imaging. Radiology 227(2):345–352PubMedGoogle Scholar
  129. McCausland AM (1992) Hysteroscopic myometrial biopsy: its use in diagnosing adenomyosis and its clinical application. Am J Obstet Gynecol 166(6 Pt 1):1619–1626; discussion 1626–1618PubMedGoogle Scholar
  130. McCausland AM, McCausland VM (1996) Depth of endometrial penetration in adenomyosis helps determine outcome of rollerball ablation. Am J Obstet Gynecol 174(6):1786–1793; 1793–1784PubMedGoogle Scholar
  131. McCluggage WG, Ellis PK, McClure N, Walker WJ, Jackson PA, Manek S (2000) Pathologic features of uterine leiomyomas following uterine artery embolization. Int J Gynecol Pathol 19(4):342–347PubMedGoogle Scholar
  132. McLucas B, Adler L, Perrella R (2001a) Uterine fibroid embolization: nonsurgical treatment for symptomatic fibroids. J Am Coll Surg 192(1):95–105PubMedGoogle Scholar
  133. McLucas B, Goodwin S, Adler L, Rappaport A, Reed R, Perrella R (2001b) Pregnancy following uterine fibroid embolization. Int J Gynaecol Obstet 74(1):1–7PubMedGoogle Scholar
  134. McLucas B, Perrella R, Adler L (2002) Embolization for the treatment of adenomyosis. AJR Am J Roentgenol 178(4):1028–1029PubMedGoogle Scholar
  135. Mercorio F, De Simone R, Di Spiezio Sardo A et al (2003) The effect of a levonorgestrel-releasing intrauterine device in the treatment of myoma-related menorrhagia. Contraception 67(4):277–280PubMedGoogle Scholar
  136. Morita M, Asakawa Y, Nakakuma M, Kubo H (2004) Laparoscopic excision of myometrial adenomyomas in patients with adenomyosis uteri and main symptoms of severe dysmenorrhea and hypermenorrhea. J Am Assoc Gynecol Laparosc 11(1):86–89PubMedGoogle Scholar
  137. Mulvany NJ, Ostor AG, Ross I (1995) Diffuse leiomyomatosis of the uterus. Histopathology 27(2):175–179PubMedGoogle Scholar
  138. Munro MG, Critchley HO, Broder MS, Fraser IS, Disorders FWGM (2011) FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 113(1):3–13PubMedGoogle Scholar
  139. Myers ER, Barber MD, Gustilo-Ashby T, Couchman G, Matchar DB, McCrory DC (2002) Management of uterine leiomyomata: what do we really know? Obstet Gynecol 100(1):8–17PubMedGoogle Scholar
  140. Nishida M (1991) Relationship between the onset of dysmenorrhea and histologic findings in adenomyosis. Am J Obstet Gynecol 165(1):229–231PubMedGoogle Scholar
  141. Oguchi O, Mori A, Kobayashi Y, Horiuchi A, Nikaido T, Fujii S (1995) Prediction of histopathologic features and proliferative activity of uterine leiomyoma by magnetic resonance imaging prior to GnRH analogue therapy: correlation between T2-weighted images and effect of GnRH analogue. J Obstet Gynaecol 21(2):107–117Google Scholar
  142. Okamoto T, Koshiyama M, Yamamoto K (2004) Rapidly growing leiomyoma in a postmenopausal woman. J Obstet Gynaecol Res 30(4):316–318PubMedGoogle Scholar
  143. Omary RA, Vasireddy S, Chrisman HB et al (2002) The effect of pelvic MR imaging on the diagnosis and treatment of women with presumed symptomatic uterine fibroids. J Vasc Interv Radiol 13(11):1149–1153PubMedGoogle Scholar
  144. Ono M, Qiang W, Serna VA et al (2012) Role of stem cells in human uterine leiomyoma growth. PLoS One 7(5):e36935PubMedPubMedCentralGoogle Scholar
  145. Outwater EK, Siegelman ES, Van Deerlin V (1998) Adenomyosis: current concepts and imaging considerations. AJR Am J Roentgenol 170(2):437–441PubMedGoogle Scholar
  146. Ozaki T, Takahashi K, Okada M, Kurioka H, Miyazaki K (1999) Live birth after conservative surgery for severe adenomyosis following magnetic resonance imaging and gonadotropin-releasing hormone agonist therapy. Int J Fertil Womens Med 44(5):260–264PubMedGoogle Scholar
  147. Parazzini F, La Vecchia C, Negri E, Cecchetti G, Fedele L (1988) Epidemiologic characteristics of women with uterine fibroids: a case-control study. Obstet Gynecol 72(6):853–857PubMedGoogle Scholar
  148. Parazzini F, Vercellini P, Panazza S, Chatenoud L, Oldani S, Crosignani PG (1997) Risk factors for adenomyosis. Hum Reprod 12(6):1275–1279PubMedGoogle Scholar
  149. Park HR, Kim MD, Kim NK et al (2005) Uterine restoration after repeated sloughing of fibroids or vaginal expulsion following uterine artery embolization. Eur Radiol 15(9):1850–1854PubMedGoogle Scholar
  150. Parker WH, Fu YS, Berek JS (1994) Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol 83(3):414–418PubMedGoogle Scholar
  151. Pattani SJ, Kier R, Deal R, Luchansky E (1995) MRI of uterine leiomyosarcoma. Magn Reson Imaging 13(2):331–333PubMedGoogle Scholar
  152. Pelage JP, Le Dref O, Soyer P et al (2000) Fibroid-related menorrhagia: treatment with superselective embolization of the uterine arteries and midterm follow-up. Radiology 215(2):428–431PubMedGoogle Scholar
  153. Pelage JP, Beregi J, LeDref O, Nonent M, Robert YH, Rymer R (2001) Uterine artery embolization for fibroids using a different end-point for embolization: preliminary results using calibrated microspheres. Radiology 221(P):356Google Scholar
  154. Pelage JP, Guaou NG, Jha RC, Ascher SM, Spies JB (2004) Uterine fibroid tumors: long-term MR imaging outcome after embolization. Radiology 230(3):803–809PubMedGoogle Scholar
  155. Pelage JP, Jacob D, Fazel A et al (2005) Midterm results of uterine artery embolization for symptomatic adenomyosis: initial experience. Radiology 234(3):948–953PubMedGoogle Scholar
  156. Phelan JP (1995) Myomas and pregnancy. Obstet Gynecol Clin N Am 22(4):801–805Google Scholar
  157. Pinto I, Chimeno P, Romo A et al (2003) Uterine fibroids: uterine artery embolization versus abdominal hysterectomy for treatment—a prospective, randomized, and controlled clinical trial. Radiology 226(2):425–431PubMedGoogle Scholar
  158. Pontis A, D’Alterio MN, Pirarba S, de Angelis C, Tinelli R, Angioni S (2016) Adenomyosis: a systematic review of medical treatment. Gynecol Endocrinol 32(9):696–700PubMedGoogle Scholar
  159. Price N, Gillmer MD, Stock A, Hurley PA (2005) Pregnancy following uterine artery embolisation. J Obstet Gynaecol 25(1):28–31PubMedGoogle Scholar
  160. Pritts EA (2001) Fibroids and infertility: a systematic review of the evidence. Obstet Gynecol Surv 56(8):483–491PubMedGoogle Scholar
  161. Prollius A, de Vries C, Loggenberg E, du Plessis A, Nel M, Wessels PH (2004) Uterine artery embolisation for symptomatic fibroids: the effect of the large uterus on outcome. BJOG 111(3):239–242PubMedGoogle Scholar
  162. Pron G (2015) Magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) treatment of symptomatic uterine fibroids: an evidence-based analysis. Ont Health Technol Assess Ser 15(4):1–86PubMedPubMedCentralGoogle Scholar
  163. Pron G, Bennett J, Common A, Wall J, Asch M, Sniderman K (2003) The Ontario Uterine Fibroid Embolization Trial. Part 2. Uterine fibroid reduction and symptom relief after uterine artery embolization for fibroids. Fertil Steril 79(1):120–127PubMedGoogle Scholar
  164. Radosa MP, Owsianowski Z, Mothes A et al (2014) Long-term risk of fibroid recurrence after laparoscopic myomectomy. Eur J Obstet Gynecol Reprod Biol 180:35–39PubMedGoogle Scholar
  165. Rammeh-Rommani S, Mokni M, Stita W et al (2005) Uterine smooth muscle tumors: retrospective epidemiological and pathological study of 2760 cases. J Gynecol Obstet Biol Reprod (Paris) 34(6):568–571Google Scholar
  166. Ravina J, Merland J, Herbetreau D, Houdart E, Bouret J, Madelenat P (1994) Embolisation pré-opératoire des fibromes utérins. Presse Med 23(33):1540PubMedGoogle Scholar
  167. Ravina JH, Vigneron NC, Aymard A, Le Dref O, Merland JJ (2000) Pregnancy after embolization of uterine myoma: report of 12 cases. Fertil Steril 73(6):1241–1243PubMedGoogle Scholar
  168. Razavi MK, Hwang G, Jahed A, Modanloo S, Chen B (2003) Abdominal myomectomy versus uterine fibroid embolization in the treatment of symptomatic uterine leiomyomas. AJR Am J Roentgenol 180(6):1571–1575PubMedGoogle Scholar
  169. Reed SD, Cushing-Haugen KL, Daling JR, Scholes D, Schwartz SM (2004) Postmenopausal estrogen and progestogen therapy and the risk of uterine leiomyomas. Menopause 11(2):214–222PubMedGoogle Scholar
  170. Rein MS, Barbieri RL, Friedman AJ (1995) Progesterone: a critical role in the pathogenesis of uterine myomas. Am J Obstet Gynecol 172(1 Pt 1):14–18PubMedGoogle Scholar
  171. Reinhold C, Atri M, Mehio A, Zakarian R, Aldis AE, Bret PM (1995) Diffuse uterine adenomyosis: morphologic criteria and diagnostic accuracy of endovaginal sonography. Radiology 197(3):609–614PubMedGoogle Scholar
  172. Reinhold C, McCarthy S, Bret PM et al (1996) Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 199(1):151–158PubMedGoogle Scholar
  173. Reinhold C, Tafazoli F, Wang L (1998) Imaging features of adenomyosis. Hum Reprod Update 4(4):337–349PubMedGoogle Scholar
  174. Reinhold C, Tafazoli F, Mehio A, et al (1999) Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. Radiographics 19 Spec No:S147–160Google Scholar
  175. Rice JP, Kay HH, Mahony BS (1989) The clinical significance of uterine leiomyomas in pregnancy. Am J Obstet Gynecol 160(5 Pt 1):1212–1216PubMedGoogle Scholar
  176. Robboy SJ, Bentley RC, Butnor K, Anderson MC (2000) Pathology and pathophysiology of uterine smooth-muscle tumors. Environ Health Perspect 108(Suppl 5):779–784PubMedGoogle Scholar
  177. Robles-Frias A, Severin CE, Robles-Frias MJ, Garrido JL (2001) Diffuse uterine leiomyomatosis with ovarian and parametrial involvement. Obstet Gynecol 97(5 Pt 2):834–835PubMedGoogle Scholar
  178. Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT (1986) Risk factors for uterine fibroids: reduced risk associated with oral contraceptives. Br Med J (Clin Res Ed) 293(6543):359–362Google Scholar
  179. Roy C, Bierry G, Ghali SE, Buy X, Rossini A (2005) Acute torsion of uterine leiomyoma: CT features. Abdom Imaging 30(1):120–123PubMedGoogle Scholar
  180. Sadan O, van Iddekinge B, van Gelderen CJ et al (1987) Oestrogen and progesterone receptor concentrations in leiomyoma and normal myometrium. Ann Clin Biochem 24(Pt 3):263–267PubMedGoogle Scholar
  181. Sahdev A, Sohaib SA, Jacobs I, Shepherd JH, Oram DH, Reznek RH (2001) MR imaging of uterine sarcomas. AJR Am J Roentgenol 177(6):1307–1311PubMedGoogle Scholar
  182. Samadi AR, Lee NC, Flanders WD, Boring JR 3rd, Parris EB (1996) Risk factors for self-reported uterine fibroids: a case-control study. Am J Public Health 86(6):858–862PubMedPubMedCentralGoogle Scholar
  183. Sawin SW, Pilevsky ND, Berlin JA, Barnhart KT (2000) Comparability of perioperative morbidity between abdominal myomectomy and hysterectomy for women with uterine leiomyomas. Am J Obstet Gynecol 183(6):1448–1455PubMedGoogle Scholar
  184. Scheurig-Muenkler C, Lembcke A, Froeling V, Maurer M, Hamm B, Kroencke TJ (2011) Uterine artery embolization for symptomatic fibroids: long-term changes in disease-specific symptoms and quality of life. Hum Reprod 26(8):2036–2042PubMedGoogle Scholar
  185. Schwartz SM (2001) Invited commentary: studying the epidemiology of uterine leiomyomata—past, present, and future. Am J Epidemiol 153(1):27–29. discussion 30PubMedGoogle Scholar
  186. Schwartz LB, Panageas E, Lange R, Rizzo J, Comite F, McCarthy S (1994) Female pelvis: impact of MR imaging on treatment decisions and net cost analysis. Radiology 192(1):55–60PubMedGoogle Scholar
  187. Schwartz LB, Zawin M, Carcangiu ML, Lange R, McCarthy S (1998) Does pelvic magnetic resonance imaging differentiate among the histologic subtypes of uterine leiomyomata? Fertil Steril 70(3):580–587PubMedGoogle Scholar
  188. Scoutt LM, McCarthy SM, Lange R, Bourque A, Schwartz PE (1994) MR evaluation of clinically suspected adnexal masses. J Comput Assist Tomogr 18(4):609–618PubMedGoogle Scholar
  189. Shozu M, Murakami K, Inoue M (2004) Aromatase and leiomyoma of the uterus. Semin Reprod Med 22(1):51–60PubMedGoogle Scholar
  190. Siegler AM, Camilien L (1994) Adenomyosis. J Reprod Med 39(11):841–853PubMedGoogle Scholar
  191. Siskin GP, Tublin ME, Stainken BF, Dowling K, Dolen EG (2001) Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging. AJR Am J Roentgenol 177(2):297–302PubMedGoogle Scholar
  192. deSouza NM, Williams AD (2002) Uterine arterial embolization for leiomyomas: perfusion and volume changes at MR imaging and relation to clinical outcome. Radiology 222(2):367–374PubMedGoogle Scholar
  193. Soysal ME, Soysal SK, Vicdan K (2001) Thermal balloon ablation in myoma-induced menorrhagia under local anesthesia. Gynecol Obstet Investig 51(2):128–133Google Scholar
  194. Spies JB, Ascher SA, Roth AR, Kim J, Levy EB, Gomez-Jorge J (2001a) Uterine artery embolization for leiomyomata. Obstet Gynecol 98(1):29–34PubMedGoogle Scholar
  195. Spies JB, Benenati JF, Worthington-Kirsch RL, Pelage JP (2001b) Initial experience with use of tris-acryl gelatin microspheres for uterine artery embolization for leiomyomata. J Vasc Interv Radiol 12(9):1059–1063PubMedGoogle Scholar
  196. Spies JB, Spector A, Roth AR, Baker CM, Mauro L, Murphy-Skrynarz K (2002a) Complications after uterine artery embolization for leiomyomas. Obstet Gynecol 100(5 Pt 1):873–880PubMedGoogle Scholar
  197. Spies JB, Roth AR, Jha RC et al (2002b) Leiomyomata treated with uterine artery embolization: factors associated with successful symptom and imaging outcome. Radiology 222(1):45–52PubMedGoogle Scholar
  198. Spies JB, Cooper JM, Worthington-Kirsch R, Lipman JC, Mills BB, Bennetati JF (2004a) Outcome of uterine embolization and hysterectomy for leiomyomas: results of a multicenter study. Obstet Gynecol Surv 59(12):819–820Google Scholar
  199. Spies JB, Allison S, Flick P et al (2004b) Polyvinyl alcohol particles and tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a randomized comparative study. J Vasc Interv Radiol 15(8):793–800PubMedGoogle Scholar
  200. Spies JB, Bruno J, Czeyda-Pommersheim F, Magee ST, Ascher SA, Jha RC (2005a) Long-term outcome of uterine artery embolization of leiomyomata. Obstet Gynecol 106(5):933–939PubMedGoogle Scholar
  201. Spies JB, Patel AA, Epstein NB, White AM (2005b) Recent advances in uterine fibroid embolization. Curr Opin Obstet Gynecol 17(6):562–567PubMedGoogle Scholar
  202. Stewart EA (2001) Uterine fibroids. Lancet 357(9252):293–298PubMedGoogle Scholar
  203. Stewart EA, Nowak RA (1996) Leiomyoma-related bleeding: a classic hypothesis updated for the molecular era. Hum Reprod Update 2(4):295–306PubMedGoogle Scholar
  204. Stewart EA, Gostout B, Rabinovici J, Kim HS, Regan L, Tempany CM (2007) Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 110(2 Pt 1):279–287PubMedGoogle Scholar
  205. Stewart EA, Shuster LT, Rocca WA (2012) Reassessing hysterectomy. Minn Med 95(3):36–39PubMedPubMedCentralGoogle Scholar
  206. Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R (2017) Epidemiology of uterine fibroids: a systematic review. BJOG. Scholar
  207. Stringer NH, Strassner HT, Lawson L et al (2001) Pregnancy outcomes after laparoscopic myomectomy with ultrasonic energy and laparoscopic suturing of the endometrial cavity. J Am Assoc Gynecol Laparosc 8(1):129–136PubMedGoogle Scholar
  208. Suginami H, Kaura R, Ochi H, Matsuura S (1990) Intravenous leiomyomatosis with cardiac extension: successful surgical management and histopathologic study. Obstet Gynecol 76(3 Pt 2):527–529PubMedGoogle Scholar
  209. Takemori M, Nishimura R, Sugimura K (1992) Magnetic resonance imaging of uterine leiomyosarcoma. Arch Gynecol Obstet 251(4):215–218PubMedGoogle Scholar
  210. Tamai K, Togashi K, Ito T, Morisawa N, Fujiwara T, Koyama T (2005) MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Radiographics 25(1):21–40PubMedGoogle Scholar
  211. Tamai K, Koyama T, Saga T et al (2008) The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol 18(4):723–730PubMedGoogle Scholar
  212. Tamaya T, Fujimoto J, Okada H (1985) Comparison of cellular levels of steroid receptors in uterine leiomyoma and myometrium. Acta Obstet Gynecol Scand 64(4):307–309PubMedGoogle Scholar
  213. Togashi K, Ozasa H, Konishi I et al (1989) Enlarged uterus: differentiation between adenomyosis and leiomyoma with MR imaging. Radiology 171(2):531–534PubMedGoogle Scholar
  214. Togashi K, Kawakami S, Kimura I et al (1993a) Uterine contractions: possible diagnostic pitfall at MR imaging. J Magn Reson Imaging 3(6):889–893Google Scholar
  215. Togashi K, Kawakami S, Kimura I et al (1993b) Sustained uterine contractions: a cause of hypointense myometrial bulging. Radiology 187(3):707–710Google Scholar
  216. Torashima M, Yamashita Y, Matsuno Y et al (1998) The value of detection of flow voids between the uterus and the leiomyoma with MRI. J Magn Reson Imaging 8(2):427–431PubMedGoogle Scholar
  217. Torigian DA, Siegelman ES, Terhune KP, Butts SF, Blasco L, Shlansky-Goldberg RD (2005) MRI of uterine necrosis after uterine artery embolization for treatment of uterine leiomyomata. AJR Am J Roentgenol 184(2):555–559PubMedGoogle Scholar
  218. Townsend DE, Sparkes RS, Baluda MC, McClelland G (1970) Unicellular histogenesis of uterine leiomyomas as determined by electrophoresis by glucose-6-phosphate dehydrogenase. Am J Obstet Gynecol 107(8):1168–1173PubMedGoogle Scholar
  219. Troiano RN, Flynn SD, McCarthy S (1998) Cystic adenomyosis of the uterus: MRI. J Magn Reson Imaging 8(6):1198–1202PubMedGoogle Scholar
  220. Tropeano G, Di Stasi C, Litwicka K, Romano D, Draisci G, Mancuso S (2004) Uterine artery embolization for fibroids does not have adverse effects on ovarian reserve in regularly cycling women younger than 40 years. Fertil Steril 81(4):1055–1061PubMedGoogle Scholar
  221. Tsushima Y, Kita T, Yamamoto K (1997) Uterine lipoleiomyoma: MRI, CT and ultrasonographic findings. Br J Radiol 70(838):1068–1070PubMedGoogle Scholar
  222. Tulandi T, Murray C, Guralnick M (1993) Adhesion formation and reproductive outcome after myomectomy and second-look laparoscopy. Obstet Gynecol 82(2):213–215PubMedGoogle Scholar
  223. Ueda H, Togashi K, Konishi I et al (1999) Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. Radiographics 19:131–145Google Scholar
  224. Utsunomiya D, Notsute S, Hayashida Y et al (2004) Endometrial carcinoma in adenomyosis: assessment of myometrial invasion on T2-weighted spin-echo and gadolinium-enhanced T1-weighted images. AJR Am J Roentgenol 182(2):399–404PubMedGoogle Scholar
  225. Walker WJ, Pelage JP (2002) Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG 109(11):1262–1272PubMedGoogle Scholar
  226. Walker WJ, Carpenter TT, Kent AS (2004) Persistent vaginal discharge after uterine artery embolization for fibroid tumors: cause of the condition, magnetic resonance imaging appearance, and surgical treatment. Am J Obstet Gynecol 190(5):1230–1233PubMedGoogle Scholar
  227. Wamsteker K, Emanuel MH, de Kruif JH (1993) Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 82(5):736–740PubMedGoogle Scholar
  228. Weichert W, Denkert C, Gauruder-Burmester A et al (2005) Uterine arterial embolization with tris-acryl gelatin microspheres: a histopathologic evaluation. Am J Surg Pathol 29(7):955–961PubMedGoogle Scholar
  229. Weinreb JC, Barkoff ND, Megibow A, Demopoulos R (1990) The value of MR imaging in distinguishing leiomyomas from other solid pelvic masses when sonography is indeterminate. AJR Am J Roentgenol 154(2):295–299PubMedGoogle Scholar
  230. Wildemeersch D, Schacht E (2002) The effect on menstrual blood loss in women with uterine fibroids of a novel “frameless” intrauterine levonorgestrel-releasing drug delivery system: a pilot study. Eur J Obstet Gynecol Reprod Biol 102(1):74–79PubMedGoogle Scholar
  231. Wood C, Maher P, Hill D (1994) Biopsy diagnosis and conservative surgical treatment of adenomyosis. J Am Assoc Gynecol Laparosc 1(4 Pt 1):313–316PubMedGoogle Scholar
  232. Wright JD, Herzog TJ, Tsui J et al (2013) Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstet Gynecol 122(2 Pt 1):233–241PubMedPubMedCentralGoogle Scholar
  233. Yamashita Y, Torashima M, Takahashi M et al (1993) Hyperintense uterine leiomyoma at T2-weighted MR imaging: differentiation with dynamic enhanced MR imaging and clinical implications. Radiology 189(3):721–725PubMedGoogle Scholar
  234. Yamashita Y, Tang Y, Abe Y, Mitsuzaki K, Takahashi M (1998) Comparison of ultrafast half-Fourier single-shot turbo spin-echo sequence with turbo spin-echo sequences for T2-weighted imaging of the female pelvis. J Magn Reson Imaging 8(6):1207–1212PubMedGoogle Scholar
  235. Yeh HC, Kaplan M, Deligdisch L (1999) Parasitic and pedunculated leiomyomas: ultrasonographic features. J Ultrasound Med 18(11):789–794PubMedGoogle Scholar
  236. Ylikorkala O, Tiitinen A, Hulkko S, Kivinen S, Nummi S (1995) Decrease in symptoms, blood loss and uterine size with nafarelin acetate before abdominal hysterectomy: a placebo-controlled, double-blind study. Hum Reprod 10(6):1470–1474PubMedGoogle Scholar
  237. Zacharia TT, O’Neill MJ (2006) Prevalence and distribution of adnexal findings suggesting endometriosis in patients with MR diagnosis of adenomyosis. Br J Radiol 79(940):303–307PubMedGoogle Scholar
  238. Zaloudek C, Hendrickson MR (2002) Mesenchymal tumors of the uterus. In: Kurman RJ, Ellenson H, Lora R, Brigitte M (eds) Blaustein’s pathology of the female genital tract. Springer, New York, p 567ffGoogle Scholar
  239. Zawin M, McCarthy S, Scoutt LM, Comite F (1990) High-field MRI and US evaluation of the pelvis in women with leiomyomas. Magn Reson Imaging 8(4):371–376PubMedGoogle Scholar
  240. Zhou J, He L, Liu P et al (2016) Outcomes in adenomyosis treated with uterine artery embolization are associated with lesion vascularity: a long-term follow-up study of 252 cases. PLoS One 11(11):e0165610PubMedPubMedCentralGoogle Scholar

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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Klinik für Diagnostische und Interventionelle Radiologie und NeuroradiologieKlinikum AugsburgAugsburgGermany

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