Ultrasound Case Record With Report

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Uterine Fibroid ultrasound cases

Diagnostic Sonography • Case Study Atlas

Uterine Fibroids

A structured ultrasound case collection covering common uterine fibroid locations and appearances, including pedunculated subserosal, subserosal, intramural, submucosal, cervical and calcified fibroids.

UTERUSULTRASOUNDCASE SERIES

Case Index

01 Pedunculated Subserosal Fibroid →

02 Subserosal Fibroid →

03 Intramural Fibroid →

04 Submucosal Fibroid →

05 Subserosal Pedunculated Fibroid →

06 Cervical Fibroid →

07 Calcified Uterine Fibroid →

Chapter 01 • Case Study

Pedunculated Subserosal Fibroid

01Clinical History

A patient presents with pelvic heaviness and intermittent lower abdominal discomfort. Ultrasound demonstrates a well-defined, predominantly solid uterine mass projecting from the serosal surface on a stalk.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of pedunculated subserosal fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Pedunculated Subserosal Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with pedunculated subserosal fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionPedunculated subserosal uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

Chapter 02 • Case Study

Subserosal Fibroid

01Clinical History

A patient presents with pelvic pressure and abdominal fullness. Sonography demonstrates a well-defined mass arising from the outer contour of the uterus.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of subserosal fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Subserosal Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with subserosal fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionSubserosal uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

Chapter 03 • Case Study

Intramural Fibroid

01Clinical History

A patient presents with heavy menstrual bleeding and dysmenorrhea. Ultrasound demonstrates a focal myometrial mass.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of intramural fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Intramural Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with intramural fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionIntramural uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

Chapter 04 • Case Study

Submucosal Fibroid

01Clinical History

A patient presents with heavy or prolonged menstrual bleeding. Ultrasound demonstrates a focal lesion immediately adjacent to the endometrial cavity.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of submucosal fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Submucosal Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with submucosal fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionSubmucosal uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

Chapter 05 • Case Study

Subserosal Pedunculated Fibroid

01Clinical History

A patient presents with pelvic discomfort and a sensation of a lower abdominal mass. Ultrasound demonstrates a large exophytic uterine lesion attached by a narrow stalk.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of subserosal pedunculated fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Subserosal Pedunculated Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with subserosal pedunculated fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionPedunculated subserosal uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

Chapter 06 • Case Study

Cervical Fibroid

01Clinical History

A patient presents with pelvic pressure, abnormal uterine bleeding, or urinary symptoms. Ultrasound demonstrates a focal mass centered in the uterine cervix.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of cervical fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Cervical Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with cervical fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionCervical uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

Chapter 07 • Case Study

Calcified Uterine Fibroid

01Clinical History

A patient with a known uterine fibroid presents for follow-up imaging. Ultrasound demonstrates a markedly echogenic lesion with calcific components.

02Ultrasound Image

Figure 1. Ultrasound image demonstrating features of calcified uterine fibroid.

03Ultrasound Morphology

Feature	Sonographic Description
Location	Calcified Uterine Fibroid involving the uterus.
Size	Measure in three orthogonal dimensions and document in cm.
Shape	Well-defined, round-to-oval or lobulated configuration.
Echogenicity	Variable, commonly hypoechoic or heterogeneous relative to the myometrium.
Margins	Generally well circumscribed.
Vascularity	Assess peripheral and internal vascularity with Color Doppler.
Associated Findings	Assess endometrial cavity distortion, degeneration, calcification, pedicle, and relationship to adjacent structures as applicable.

04Ultrasound Report

Uterus demonstrates a well-defined focal solid mass consistent with calcified uterine fibroid.

Document lesion size, exact uterine location, relationship to the endometrial cavity and serosal surface, and Doppler vascularity.

Assess for associated degeneration, calcification, cystic change, and mass effect where present.

05Impression

Sonographic ImpressionCalcified uterine fibroid.

06Recommendation

Correlate with clinical symptoms and gynecologic examination. Document size and location for follow-up comparison when clinically indicated. Consider additional imaging when the lesion is atypical, poorly characterized, or when further anatomical mapping is required.

07Learning Points

Identify the uterine compartment and surface relationship of the fibroid.

Record three-dimensional measurements and describe the lesion's echotexture.

Use Color Doppler to assess vascularity and, in pedunculated lesions, the feeding pedicle.

Assess for endometrial distortion, degeneration, calcification, and mass effect on adjacent structures.

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