Fibroids are growths of tissue of varying size on the uterine wall. They are usually not cancerous, but should be closely monitored. A doctor may suspect a woman has fibroids when a pelvic examination shows an irregular shape to the uterus or if a woman complains of long, painful periods. Many women have no symptoms, but in some cases uterine fibroids can cause infertility, pelvic pain, and changes in the menstrual cycle. Tests are performed to make the final diagnosis of uterine fibroids so that a physician can determine an appropriate course of treatment.
Ultrasound
An ultrasound is a test commonly used during pregnancy. Because ultrasounds are effective in providing a view of the uterus they can be safely used to check for uterine fibroids as well. Women may be prone to developing uterine fibroids during pregnancy. The benefit of this test is that it is a noninvasive procedure and does not involve exposure to radiation.
MRI
An MRI may be slightly less comfortable than ultrasound testing because the woman must stay within a small cylinder for the procedure. An MRI gives the doctor a better image of the ovaries and reproductive tract. In MRI images, the fibroids will be distinct and clear, appearing darker than the rest of the uterus. Due to the expense of the test, an MRI is usually only ordered by physicians if an ultrasound did not provide a clear enough image of the uterus.
CT Scan
A CT scan is a noninvasive test that takes images of internal organs, tissue, and other parts of the body. A physician may order a CT scan for fibroids if an MRI is not an option because the woman has metal or implants in the body, has claustrophobia, or cannot fast due to a medical condition such as diabetes. Unlike an MRI, a CT scan does not require contrast material, which can cause severe reactions in those with kidney problems. A CT gives a more detailed image than an X-ray and may provide images of similar quality to an ultrasound, but it is a more expensive diagnostic tool.
Hysteroscopy
This test is used only if a woman is having complications, such as infertility, pain, or heavy menstruation. A small camera is inserted in the vaginal opening and passed through the cervix. Although a slightly more invasive technique, it gives the doctor a better view of the fibroids. Some cramping and minor bleeding may occur from the microscope passing through the cervix.
Uterine X-ray
This test is also slightly invasive because a dye must be injected through the cervix. This dye then shows the uterus and fallopian tubes on an X-ray, providing the doctor with information regarding blocked fallopian tubes that would explain infertility. This test can also be somewhat painful and may cause cramping and bleeding.
Other Tests
Additional tests, called endometrial biopsy and dilation and curettage (D & C), are used to obtain part of the uterine lining. Both of these tests are slightly invasive and are only done, if needed, to rule out other causes of heavy or lengthy periods.
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