Sonography of the Uterine Myometrium: Myomas and Beyond

Pelvic sonography remains the imaging modality of choice for initial evaluation of myometrial pathology. The advent of vaginal sonography and color Doppler sonography have allowed for major refinements in detection and accurate diagnoses of common disorders affecting the uterus, particularly myomas and adenomyosis. Pelvic MR imaging plays an important role in gynecologic imaging because it depicts details of myometrium and junctional zone, is more reproducible, and is less operator-dependent compared with sonography. Because of its higher cost and lesser availability, MR imaging is usually reserved for pretreatment planning and for problem solving in patients for whom the ultrasound is inconclusive, not feasible, or technically suboptimal.