A 30-year-old woman with multiple uterine fibroids desires myomectomy. Preoperative MRI pelvis is planned for mapping. Which statement BEST describes the role of MRI in fibroid mapping before surgery?
- A MRI has no role; transvaginal ultrasound alone is sufficient for all cases
- B MRI is the gold standard for fibroid mapping and accurately distinguishes fibroids from adenomyosis, guides surgical approach, and detects sarcomatous features ✓
- C MRI is only indicated when malignancy is suspected on ultrasound
- D MRI is routinely used only for guiding focused ultrasound surgery (FUS), not for myomectomy planning
Correct answer: B. MRI is the gold standard for fibroid mapping and accurately distinguishes fibroids from adenomyosis, guides surgical approach, and detects sarcomatous features
Explanation
MRI is the most accurate modality for fibroid mapping (sensitivity >90% for small fibroids), reliably distinguishes fibroids from adenomyosis, identifies FIGO type, detects sarcomatous features (ill-defined margins, high T2 signal, restricted diffusion), and guides surgical planning. ACOG and RCOG recommend MRI when ultrasound is equivocal or for surgical planning in complex cases.
Reference: ACOG Practice Bulletin on Uterine Leiomyomas, 2018 (reaffirmed 2022) ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.