Figure 22a. Uterine leiomyomas treated with GnRH analog. B = bladder, * in a and c = ovary. Sagittal T2-weighted (a) and contrast-enhanced fat-suppressed T1-weighted (b) images obtained before treatment and T2-weighted image obtained after GnRH analog therapy (c) show multiple uterine leiomyomas. The largest leiomyoma is in the uterine fundus (short arrows). Before treatment, this lesion demonstrates high signal intensity on the T2-weighted image (a) and marked enhancement on the contrast-enhanced image (b). The volume of this lesion is reduced after treatment (c). In contrast, the small leiomyomas in the posterior myometrium (arrowheads) are unchanged after treatment (c). Before treatment, these lesions demonstrate low signal intensity on the T2-weighted image (a) and weak enhancement on the contrast-enhanced image (b). The large leiomyoma in the posterior myometrium (long arrow) is also unchanged after treatment (c), even though it demonstrates enhancement before treatment (b).