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Ultrasound signs of uterine pathology in non-pregnant women
Last reviewed: 23.04.2024
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Pathology of the uterus
Myomas (fibromas)
Myoma can be visualized differently by ultrasound. Most of them are defined as multiple, with clear contours, homogeneous gipoehogenic structure, nodal formations, subserous, submucous or interstitial. Old fibroids become hyperechoic, some of them acquire a mixed echogenicity as a result of central necrosis. Bright hyperechoic structures can be identified as a result of calcification. Rapidly growing myoma, for example, during pregnancy, simulates hypoechoic cysts. It is necessary to study in different planes for the differentiation of myoma and tubo-thoracic formation. Some fibroids grow on the stalk. Uterine fibroids can move the posterior wall of the bladder.
Myomas can have kalidinata, represented by bright hyperechoic structures with a distal shadow. Myoma is almost always multiple and often breaks the normal contour or displaces the uterine cavity.
Myomas can also be localized in the cervix, can move or cause obstruction of the cervical canal.
Developmental anomalies
A double-horned uterus can be identified by the presence of two cavities or by revealing one and the second uterine bottom in a transverse scan. Careful scanning is necessary in order not to confuse the bicornic uterus and ovarian formations. The doubled uterus has two cavities and two necks: in the presence of ovarian formation or formation in another organ, only one uterine cavity and a cervical canal will be defined.
[Pathology of the endometrium
Normal ehostruktura largely varies depending on the stage of the menstrual cycle. In the proliferative phase (at the beginning of the menstrual cycle), the endometrium looks thin and hypoechoic. In the perivascular phase (in the middle of the cycle), the central part of the endometrium becomes hyperechoic and is surrounded by a hypoechoic rim. With the onset of menstruation, the endometrium becomes completely hyperechoic and thickened due to detachment of tissue and formation of blood clots.
In women with congenital absence of a hymen opening or in women who have had ritual suturing, blood can accumulate in the uterine cavity (with the development of hematomas) or in the vagina (hematocolpos) and will look hypoechoic compared to the endometrium.
The uterine cavity can be filled with pus during inflammation (pyometra). Echographically, a hypoechoic zone with an internal echostructure will be determined. Inflammatory exudate can also be collected in the fallopian tubes (hydrosalpinx) and spread in the cervical space.
Malignant neoplasms
Education in the uterus with a fuzzy contour can be malignant and more often is endometrial cancer. Endometrium thickens, gipoehogennaya tumor can spread into the myometrium. With progression, necrosis zones can be formed with the appearance of an inhomogeneous echostructure: the uterine cavity expands.
Small carcinoma (cancer) of the cervix can not always be detected by ultrasound.
Early stages of cervical cancer are very difficult to detect with ultrasound. Any zone with a fuzzy contour in the neck is suspicious for the presence of a malignant process (most of the myomas are clearly limited, often in them calcification is determined). If the tumor is large, the ehostruktura is heterogeneous and very variable. A tumor can infiltrate surrounding tissues, while carefully examining the bladder, vagina, rectum.
Internal endometriosis
Hypoechoic areas in the myometrium next to the endometrium may appear due to adenomyosis (endometriosis of the uterus). These sites are visualized more clearly during and immediately after menstruation. Do not take small retention cysts in the cervix, located close to the cervical canal, behind endometrioid heterotopia. Education in a small pelvis can be represented by endometrioma or an ectopic pregnancy.
Remember: it is necessary to change the sensitivity level at ultrasound examination of the pelvic organs at all times in order to obtain the optimal image.