ARDMS (American Registry for Diagnostic Medical Sonography) Practice Test

What is a common ultrasound feature of fibroids?

1. They appear as anechoic areas

2. They typically appear as hypoechoic or heterogeneously echogenic areas

3. They show uniform echogenicity

4. They are always visible as calcified structures

The correct answer is: They typically appear as hypoechoic or heterogeneously echogenic areas

Fibroids, also known as uterine leiomyomas, commonly present on ultrasound as hypoechoic or heterogeneously echogenic areas. This characteristic is due to the fibrous tissue composition of the tumors, which usually contrasts with the normal myometrium, often making fibroids appear darker (hypoechoic) or mixed in echogenicity compared to the surrounding uterine tissue. The hypoechoic nature can vary depending on factors such as the size of the fibroid, its degree of degeneration, or its specific location within the uterus. This variability can result in some fibroids appearing heterogeneously echogenic due to different tissue components, necrosis, or calcium deposits inside the fibroid. Hence, option B effectively captures the most typical appearance of fibroids on ultrasound. In contrast, other options such as presenting as anechoic areas do not apply, as fibroids are not fluid-filled like cysts, which would appear anechoic. The option concerning uniform echogenicity is misleading because fibroids do not maintain a uniform appearance; instead, their echogenicity can vary based on their internal structure and any degenerative changes. Finally, while some fibroids can undergo calcification, they do not universally present as calc