Figure 3d. Maturing hemorrhagic leiomyoma in a postpartum 34-year-old woman with lower abdominal discomfort and a palpable mass. (a, b) Sagittal (a) and axial (b) T2-weighted fast SE MR images show a normal uterus (arrow in a, straight arrow in b) and ovaries (curved arrows in b). There is a large, heterogeneous subserosal leiomyoma (*) that extends superiorly from the anterior body and fundus of the uterus. (c) Axial T1-weighted spoiled gradient-echo MR image obtained at the same level as b shows diffuse very high signal intensity within the mass (*); the very high signal intensity represents methemoglobin from subacute hemorrhage. (d) Axial T1-weighted SE MR image obtained 4 months later shows maturation of the hemorrhage with high signal intensity confined to the rim (arrows). Both patterns of high signal intensity have been described in hemorrhagic degeneration of leiomyomas.