Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 8;33(2):e12.
doi: 10.3346/jkms.2018.33.e12.

A Fast 3-Dimensional Magnetic Resonance Imaging Reconstruction for Surgical Planning of Uterine Myomectomy

Sa Ra Lee  1 , Young Jae Kim  2 , Kwang Gi Kim  3
Affiliations

A Fast 3-Dimensional Magnetic Resonance Imaging Reconstruction for Surgical Planning of Uterine Myomectomy

Sa Ra Lee et al. J Korean Med Sci. .

Abstract

Background: Uterine myoma is the most common benign gynecologic tumor in reproductive-aged women. During myomectomy for women who want to preserve fertility, it is advisable to detect and remove all myomas to decrease the risk of additional surgery. However, finding myomas during surgery is often challenging, especially for deep-seated myomas. Therefore, three-dimensional (3D) preoperative localization of myomas can be helpful for the surgical planning for myomectomy. However, the previously reported manual 3D segmenting method takes too much time and effort for clinical use. The objective of this study was to propose a new method of rapid 3D visualization of uterine myoma using a uterine template.

Methods: Magnetic resonance images were listed according to the slide spacing on each plane of the multiplanar reconstruction, and images that were determined to be myomas were selected by simply scrolling the mouse down. By using the selected images, a 3D grid with a slide spacing interval was constructed and filled on its plane and finally registered to a uterine template.

Results: The location of multiple myomas in the uterus was visualized in 3D and this proposed method is over 95% faster than the existing manual-segmentation method. Not only the size and location of the myomas, but also the shortest distance between the uterine surface and the myomas, can be calculated. This technique also enables the surgeon to know the number of total, removed, and remaining myomas on the 3D image.

Conclusion: This proposed 3D reconstruction method with a uterine template enables faster 3D visualization of myomas.

Keywords: Fertility; Imaging; Myoma; Myomectomy; Three-dimension.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Flowchart for visualizing a uterus fibroid. DICOM = Digital Imaging and Communications in Medicine, MPR = multiplanar reconstruction, ROI = region of interest, 3D = three-dimensional.
Fig. 2
Fig. 2
Maximum area of a uterus on each plane of 2D MRI. (A) Axial plane. (B) Sagittal plane. (C) Coronal plane. (D) The uterine template model constructed according to the size of the uterus. 2D = two-dimensional, MRI = magnetic resonance imaging.
Fig. 3
Fig. 3
Process of selecting the fibroid slides on each plane. (A) Axial plane. (B) Coronal plane. (C) Sagittal plane.
Fig. 4
Fig. 4
3D visualization results of a fibroid. (A) The size and distance are calculated using a grid to express the shortest distance. (B) The direction from the uterine serosal surface to the fibroid center. 3D = three-dimensional.
Fig. 5
Fig. 5
Counting and changing the color of a selected fibroid during surgery. (A) A total of four fibroids were on the screen and a selected fibroid turn to green. (B) A total of three fibroids were on the screen after removing the selected green fibroid.
Fig. 6
Fig. 6
Comparison of image of a uterus and a fibroid obtained by two different methods. (A) Manual segmentation method. (B) Our proposed method.
See this image and copyright information in PMC

References

    1. Donnez J, Jadoul P. What are the implications of myomas on fertility? A need for a debate? Hum Reprod. 2002;17(6):1424–1430. - PubMed
    1. Buttram VC, Jr, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36(4):433–445. - PubMed
    1. Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect. 2003;111(8):1037–1054. - PMC - PubMed
    1. Broder MS, Goodwin S, Chen G, Tang LJ, Costantino MM, Nguyen MH, et al. Comparison of long-term outcomes of myomectomy and uterine artery embolization. Obstet Gynecol. 2002;100(5 Pt 1):864–868. - PubMed
    1. Kim HS, Oh SY, Choi SJ, Park HS, Cho GJ, Chung JH, et al. Uterine rupture in pregnancies following myomectomy: a multicenter case series. Obstet Gynecol Sci. 2016;59(6):454–462. - PMC - PubMed