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Page: Diagnosis
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Diagnosis is usually accomplished by bimanual examination, better yet by gynecologic ultrasonography. Sonography will depict the fibroids as focal masses with a heterogeneous texture, which usually cause shadowing of the ultrasound beam. In cases where a more precise assay of the fibroid burden of the uterus is needed, also magnetic resonance imaging (MRI) can be used to generate a depiction of the size and location of the fibroids within the uterus. While no imaging modality can clearly distinguish between the benign uterine leiomyoma and the malignant uterine leiomyosarcoma, the rarity of the latter and the prevalence of the former make it, for practical purposes, a non-issue unless evidence of local invasion is present, though more recent studies have improved diagnostic capabilities using MRI. For this reason, biopsy is rarely performed and if performed, is rarely diagnostic.
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