Uterine Fibroids: Diagnosis and Misinterpretation Risks

Uterine fibroids

Recently, during a CT scan of my lower abdomen, a suspected uterine fibroid was unexpectedly found.
I would like to know if this type of examination will definitely detect it, or is there a possibility of misdiagnosis? What is the likelihood of that? I sometimes experience menstrual pain, but sometimes I don't.
However, my menstrual cycle has changed; over the past two months, the flow has decreased, and the blood on the sanitary pads is a dark brownish-black color.
The duration hasn't extended, lasting about five days, but I feel some bloating in my lower abdomen and have experienced anemia.
Three months ago, I had an ultrasound that showed no issues.
Since it is currently my menstrual period, I understand that an ultrasound might not be accurate, so I wanted to consult with a doctor first.
Thank you.

xuan, 10~19 year old female. Ask Date: 2017/06/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Recently, during a CT scan of the lower abdomen, a suspected uterine fibroid was unexpectedly found.
I would like to know if this type of examination will definitely detect it, or is there a possibility of misdiagnosis? What is the likelihood of that? I sometimes experience menstrual pain, but sometimes I don't.
However, my menstrual cycle has changed recently; the amount of bleeding has decreased over the past two months, and the blood on the sanitary pads is a deep brownish-black color.
The duration of my period remains about five days, but I feel some bloating in my lower abdomen and have experienced anemia.
Three months ago, I had an ultrasound that showed no issues.
Since it is currently my menstrual period, the ultrasound results might not be accurate, so I wanted to consult with a doctor here first.
Thank you.

Answer: It is advisable to go to a larger hospital for a repeat ultrasound to confirm the findings.

Reply Date: 2017/06/02

More Info

Uterine fibroids, also known as leiomyomas, are non-cancerous growths of the uterus that can vary in size, number, and location. They are quite common, especially in women of reproductive age, and can cause a range of symptoms, including changes in menstrual patterns, pelvic pain, and pressure symptoms. Your concern about the possibility of misinterpretation of CT findings is valid, and I will address your questions regarding the diagnosis and potential misinterpretation risks.

When a CT scan is performed, it can provide detailed images of the pelvic organs, including the uterus. While CT scans are generally reliable for identifying uterine fibroids, they are not the primary imaging modality for this purpose. Ultrasound is often the first-line imaging technique used to evaluate the uterus for fibroids due to its effectiveness, safety, and cost-effectiveness. However, CT scans can still detect fibroids, especially if they are large or if there are associated complications.

Regarding the accuracy of CT scans in detecting fibroids, the likelihood of misinterpretation can depend on several factors, including the size and location of the fibroid, the experience of the radiologist, and the quality of the imaging. While CT scans are generally accurate, there is a small chance that a fibroid could be missed or mischaracterized, particularly if it is small or if there are overlapping structures in the imaging. The misinterpretation rate is not precisely defined but is considered low, especially in experienced hands. However, it is essential to correlate imaging findings with clinical symptoms and other diagnostic tests.

In your case, the symptoms you describe—changes in menstrual flow, abdominal fullness, and potential anemia—could be associated with uterine fibroids, but they could also be indicative of other conditions, such as endometriosis, adenomyosis, or even hormonal imbalances. The fact that your menstrual flow has changed and that you are experiencing abdominal fullness warrants further investigation.

It is also important to note that the appearance of dark brown or black menstrual blood can be normal, especially if it is older blood that has taken longer to exit the uterus. However, if you are experiencing significant changes in your menstrual cycle or symptoms such as anemia, it is crucial to follow up with your healthcare provider for further evaluation.

In terms of next steps, I recommend discussing the findings of your CT scan with your healthcare provider, who may suggest a follow-up ultrasound to confirm the presence of fibroids and assess their size and location. Additionally, they may consider other diagnostic tests, such as a hysteroscopy or MRI, if necessary, to obtain a clearer picture of your uterine health.

In summary, while CT scans can detect uterine fibroids, they are not infallible, and there is a small risk of misinterpretation. Given your symptoms and the recent findings, it is essential to have a thorough discussion with your healthcare provider to determine the best course of action for diagnosis and management. Regular monitoring and appropriate imaging can help ensure that any potential issues are identified and addressed promptly.

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