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Figure 3c. Fibroid passage requiring hysteroscopic resection. (a, b) Sagittal single-shot fast SE T2-weighted (4.4/64) (a) and gadolinium-enhanced fat-suppressed 3D T1-weighted VIBE (4.5/1.9, 15° flip angle) (b) MR images obtained prior to UAE show a dominant fibroid in the center of the uterus that is mostly sub-mucosal. Note the heterogeneous enhancement of the fibroid in b. (c) On a sagittal gadolinium-enhanced fat-suppressed 3D T1-weighted VIBE MR image (4.5/1.9, 15° flip angle) obtained 27 days after UAE, the dominant fibroid is heterogeneous and enhances less than the adjacent myometrium. The fibroid has prolapsed through the open cervix into the vaginal fornix, with its stalk attached to the posterior uterine wall (arrow). (d) Follow-up sagittal gadolinium-enhanced fat-suppressed 3D T1-weighted VIBE MR image (4.5/1.9, 15° flip angle) obtained 2 days after hysteroscopic removal of the prolapsing fibroid shows residual tissue at the site of attachment (arrow). Note that both the endocervical and endovaginal canals have returned to their native configurations.
