A 38-year-old woman with symptomatic uterine fibroids undergoes a T2-weighted MRI pelvis for surgical planning. Regarding typical leiomyomas, which of the following best describes their signal characteristics on T2-weighted MRI?
- A High signal intensity, similar to the endometrium
- B Low signal intensity, similar to skeletal muscle ✓
- C Mixed signal with fluid-fluid levels
- D Isointense to the junctional zone
Correct answer: B. Low signal intensity, similar to skeletal muscle
Explanation
Typical leiomyomas are well-circumscribed masses of smooth muscle and fibrous tissue that appear homogeneously hypointense (low signal) on T2-weighted MRI, resembling skeletal muscle. This low signal distinguishes them from adenomyosis, which shows a thickened junctional zone with bright foci. High signal on T2 suggests degeneration or a different pathology such as leiomyosarcoma, which often shows heterogeneous high signal.
Reference: Diagnostic Imaging: Gynecology, 2nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.