Med Sci Monit,2005:115}:M33-38 Liu Cet al-DE images of uterine leiomyomas Figure 5. X-ray DEl image of sample l, the microstructure picture(A)and the partially magnified image(B)of the small rectangular area in picture A tion and the cavum of liquefied uterine leiomyomas are ation of the center region of the uterine leiomyoma is more ery clearly seen. serious than in other regions. There is an extraordinarily large cavum with irregular shape as shown in Figure 5(B),a partially magnified image of Figure 5(A). The large cavum forms the inside angiorrhexis of the uterine leiomyoma. The burble structure of uterine leiomyomas can be distinct- These can show the developmental progress of the necrosis ter. At the same time, a small cavum(denoted by an arrow bodings of uterine leiomyoma canceration as wey al fore. ly seen in Figure 8(B). Their fiber is about 20 um in diame- of uterine leiomyoma. They are one of the potenti in Figure 3(B))obviously appears due to the liquid degen- eration In Figure 3(C), the bundle-shaped myomatous fib- CONCLUSIONS an be distinctly seen in the left part of this picture; thei size is about 50 um in diameter and they are packed togeth- DEI images can clearly show the internal microstructures er closely. There is also the fiber rupture which results from of uterine leiomyomas, including the burble structure, hy- the uniformity or asymmetric liquefaction of the uterine lei- aline degeneration and rupture of muscle fibers, red de- omyoma as shown in Figure 3(C)by the arrow. In the cent- generation, and cavum of myomatous inside uterine leia- er of the uterine leiomyoma there is large-scale degenera- as. The internal hyaline degeneration and the cavum tion Blurry and disordered muscle fiber is shown in Figure of liquefied uterine leiomyomas can be shown very clear 3(D). There are a few uterine leiomyoma fibers which are ly in the refraction image. The burble structure of uterine about several hundreds um length and about 30 um in di- leiomyomas, the rupture of muscle fiber, conglomeration ameter. Some fibers have been assembled and form the con- and cavum can be displayed in images which were record- glomeration, whose size is unclear (the black arrow posi- ed at the top of the rocking curve. Therefore, DEI is a very tions in Figure 3(D). At the same time there is a big cavum valuable diagnostic method in that we can directly observ (the white arrow position in Figure 3(D)). Furthermore, the internal microstructures of organs or soft tissues, and the microstructure of a myomatous fiber with a diameter the complexity of performing a large number of patholo- of about 30 um can be distinctly shown inside the cavum. All these irregular structures are special symptoms of uter- myoma and can be very useful in finding malignant REFERENCES: pathological changes in uterine leiomyomas. sson M et al: Expression of Bcl-2, Bcl-x, For sample lI there are some small bright spots which are McL-l Bax and Bak in human leiomyomas and myometrium calcification of the uterine leiomyoma because of the cal- Biochemistry Molecular Biology, 2002: 80: 77-83 cium salt deposition in it over a long time( Figure 4(A) There are also several smooth muscle fibers which are blur- and the bundle of fibers cannot be gdd4919:15145 4(A). The partially magnified image Figure 4(B)enables us 3. Xu J. Yu Z, Jiang W: CT diagnosis value of hysteromyoma(add 71 to see some irregular microstructures of uterine leiomyo- ma tissue. These structures have pole or petal shape with a 4. Liu L, Zhou S: Image diagnosis of broad ligament leiomyoma length of approximately a few hundred micrometers. They J China Radiology, 2000: 34: 118-21(in Chinese) are red degeneration resulted from congestion, thrombo 5. Suortti P, Thomlinson W: Medical application of synchrotron radiation. Phys Med BioL, 2003; 48: Rl-R35 sis, hemolysis, and red-cell exosmosis. The spread of the 6. Zhong Z, Thomlinson w, Chapman D et al: Implementation of petal-shape structure is the most distinct characteristic of enhanced imaging experiments: at the NSLS and AsP Nue Instrum Meth Phys Res, 2000: 450: 556-b8 There are some small calcified substances to be seen in sam trast techniques: diffraction enhanced imaging and propagation. Proc of SPlE.2003:5030:26673 ple Ill, as shown in Figure 5(A). This shows that the degener- MI37tion and the cavum of liquefi ed uterine leiomyomas are very clearly seen. Microstructures The burble structure of uterine leiomyomas can be distinct￾ly seen in Figure 3(B). Their fi ber is about 20 µm in diame￾ter. At the same time, a small cavum (denoted by an arrow in Figure 3(B)) obviously appears due to the liquid degen￾eration. InFigure 3(C), the bundle-shaped myomatous fi b￾er can be distinctly seen in the left part of this picture; their size is about 50 µm in diameter and they are packed togeth￾er closely. There is also the fi ber rupture which results from the uniformity or asymmetric liquefaction of the uterine lei￾omyoma as shown in Figure 3(C) by the arrow. In the cent￾er of the uterine leiomyoma there is large-scale degenera￾tion. Blurry and disordered muscle fi ber is shown in Figure 3(D). There are a few uterine leiomyoma fi bers which are about several hundreds µm length and about 30 µm in di￾ameter. Some fi bers have been assembled and form the con￾glomeration, whose size is unclear (the black arrow posi￾tions in Figure 3(D)). At the same time there is a big cavum (the white arrow position in Figure 3(D)). Furthermore, the microstructure of a myomatous fi ber with a diameter of about 30 µm can be distinctly shown inside the cavum. All these irregular structures are special symptoms of uter￾ine leiomyoma and can be very useful in fi nding malignant pathological changes in uterine leiomyomas. For sample II there are some small bright spots which are calcifi cation of the uterine leiomyoma because of the cal￾cium salt deposition in it over a long time (Figure 4(A)). There are also several smooth muscle fi bers which are blur￾ry and the bundle of fi bers cannot be seen clearly inFigure 4(A). The partially magnifi ed image Figure 4(B) enables us to see some irregular microstructures of uterine leiomyo￾ma tissue. These structures have pole or petal shape with a length of approximately a few hundred micrometers. They are red degeneration resulted from congestion, thrombo￾sis, hemolysis, and red-cell exosmosis. The spread of the petal-shape structure is the most distinct characteristic of red degeneration. There are some small calcifi ed substances to be seen in sam￾ple III, as shown in Figure 5(A). This shows that the degener￾ation of the center region of the uterine leiomyoma is more serious than in other regions. There is an extraordinarily large cavum with irregular shape as shown in Figure 5(B), a partially magnifi ed image of Figure 5(A). The large cavum forms the inside angiorrhexis of the uterine leiomyoma. These can show the developmental progress of the necrosis of uterine leiomyoma. They are one of the potential fore￾bodings of uterine leiomyoma canceration as well. CONCLUSIONS DEI images can clearly show the internal microstructures of uterine leiomyomas, including the burble structure, hy￾aline degeneration and rupture of muscle fi bers, red de￾generation, and cavum of myomatous inside uterine leio￾myomas. The internal hyaline degeneration and the cavum of liquefi ed uterine leiomyomas can be shown very clear￾ly in the refraction image. The burble structure of uterine leiomyomas, the rupture of muscle fi ber, conglomeration and cavum can be displayed in images which were record￾ed at the top of the rocking curve. Therefore, DEI is a very valuable diagnostic method in that we can directly observe the internal microstructures of organs or soft tissues, and the complexity of performing a large number of patholo￾gy slices is avoided. REFERENCES: 1. Wu X, Blanck A, Olovsson M et al: Expression of Bcl-2, Bcl-x, Mcl-1, Bax and Bak in human uterine leiomyomas and myometrium during the menstrual cycle and after menopause. Journal of Steroid Biochemistry & Molecular Biology, 2002; 80: 77–83 2. Ueda H, Togashi K, Konishi I et al: Unusual appearances of uter￾ine leiomyomas: MR imaging fi ndings and their histopathologic back￾grounds. Radiographics, 1999; 19: S131–S145 3. Xu J, Yu Z, Jiang W: CT diagnosis value of hysteromyoma (add 71 example analysis ). Radiology Practice, 2000; 15: 187–189 (in Chinese) 4. Liu L, Zhou S: Image diagnosis of broad ligament leiomyoma. J China Radiology, 2000; 34: 118–21 (in Chinese) 5. Suortti P, Thomlinson W: Medical application of synchrotron radiation. Phys Med Biol, 2003; 48: R1–R35 6. Zhong Z, Thomlinson W, Chapman D et al: Implementation of diffraction enhanced imaging experiments: at the NSLS and ASP. Nucl Instrum Meth Phys Res, 2000; 450: 556–68 7. Fiedler S, Pagot E, Cloetens P et al: Evaluation of two phase con￾trast techniques: diffraction enhanced imaging and propagation. Proc of SPIE, 2003; 5030: 266–73 Figure 5. X-ray DEI image of sample III, the microstructure picture (A) and the partially magnifi ed image (B) of the small rectangular area in picture A. A B Med Sci Monit, 2005; 11(5): MT33-38 Liu C et al – DEI images of uterine leiomyomas MT37 MT