P33.01: Can fibroids be demonstrated on 3-dimensional elastrography?



To explore the potential of 3-dimensional trans-vaginal elastography in the evaluation of fibroids.


10 women with known fibroids attending for trans-vaginal ultrasound were recruited to have 3-dimensional trans-vaginal ultrasound elastography. Stradwin software (http://mi.eng.cam.ac.uk/∼rwp/stradwin/) running on an Ultrasonix Sonix RP was used to acquire the RF data and calculate strain images in real time. This software uses a colour wash to mask areas where the strain data is unreliable due to signal decorrelation. Information about the participant's age, uterine position, B-mode ultrasound result, and other imaging were recorded. The elastograms were analysed with reference to the B-mode image for whether (a) the fibroid could be identified in 3 orthogonal planes (b) the endometrium identified on the elastogram.


The average age of the 10 women was 52.4 years and the average uterus size of 72.4 mm (range 60–102 mm). 50% of women had anteverted uteri and 50% retroverted uteri. In all 10 patients good quality elastogram images (with minimal colour wash) were obtained. In 100% of cases the largest fibroid in each uterus could be demonstrated in 3 orthogonal planes on the elastogram. In 60% of participants the endometrium could be identified on the elastogram as a linear area of softness. In one patient a suspected sub-mucosal fibroid seen on the elastogram but not conventional ultrasound was confirmed by subsequent hysteroscopy.


Fibroids can be demonstrated with 3-dimensional elastography and their position shown in orthogonal planes. This may help to differentiate sub-mucosal and intra-mural fibroids when conventional ultrasound is inconclusive.