Ultrasound signs of ovarian pathology

Pathology of the ovaries

Normal ovaries are usually less echogenic. Than myometrium and less homogeneous due to small follicles. Ovarian imaging in postmenopausal women, especially after age 50, may be difficult.

Ovarian Cysts

The follicle is the physiological "cyst" of the ovary, which usually disappears in the second phase of the menstrual cycle. If there is no rupture of the follicle in the middle of the cycle, the follicular cyst develops, which is one of the most common ovarian cysts; The cyst may have a diameter of more than 3 cm. Immediately after the rupture of the cyst, fluid in the anterior space can be detected.

Retention cysts have even contours, anehogennye, have good distal pseudo-enhancement and are always benign. Paraovarial cysts develop from rudimentary embryonic pelvic structures.

With ultrasound, ovarian cysts can be anechogenic, almost solid, or have a mixed echogenicity due to hemorrhage into the cavity of the cyst, septum, and parietal growths. Multicameral cysts have a pronounced enhancement of the posterior wall, a variable internal echostructure, and are most often malignant.

Small or medium sized ovarian cysts located behind the uterus or bladder may not be visualized, especially if the bladder is not full enough. Large ovarian cysts are more often located above the uterine fundus with a filled bladder and can cause bladder displacement. Large cysts can be mistaken for a bladder: they need to be identified.

The dermoid cyst (cystic teratoma) is visualized by a solid or mixed echogenicity structure with areas of calcification of bones or teeth present in the cyst giving an acoustic shadow. If there is any doubt, radiographs of the pelvic organs should be performed.

Echinococcal (parasitic) cyst of small pelvis

Parasitic cysts, often multiple, may have different sizes and are located almost everywhere; some cysts have septa. If there is a suspicion of echinococcosis, ultrasound examination of the liver and radiography of the chest should be performed to exclude the presence of such cysts.

Solid ovarian formations

Solid formations are rare and often undergo necrosis or internal hemorrhage by the time they are detected during echography. Solid ovarian formations can be confused with uterine fibroids on the legs, and it is necessary to carefully search for the connection between education and the uterus.

Cystic formations in the pelvis in women in the postmenopausal period are often malignant.

Inflammatory diseases of the pelvic organs

In inflammatory diseases of the pelvic organs may occur spikes, tissue displacement, displacement of the uterus or ovaries, fixation and changes in the echogenicity of parametrical tissues. Nevertheless, echographic data can be normal, and clinical examination - more accurate. Tuberculosis of the pelvic organs according to the data of echography can not be differentiated from other inflammatory processes in the pelvis. The revealed formation can appear an endometrioma, an abscess or an ectopic pregnancy. An accurate diagnosis can be quite difficult.

Fluid in the pelvis (ascites)

When determining fluid in a small pelvis, you can assume the presence of ascites, blood, pus, or contents of the ruptured cyst. To identify the fluid, it is necessary to perform research in various planes.

The fluid can be completely anechogenous or contain internal echostructures due to a suspension. Fluids can also be detected in the vagina and in the uterine cavity.

There are many reasons for the appearance of formations in the pelvis. Echography can not always differentiate these formations.

Abscesses in the pelvis

Any localized, complex echostructure pelvic formation may be inflammatory, however, pyogenic and tubercular inflammation echographically look the same. It is often impossible to accurately indicate the localization and etiology of the formation of inflammatory genesis: therefore, a very important clinical study.