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Common Findings on Pelvic Ultrasound

By Diane Ursu
Complex ovarian cyst as seen on pelvic ultrasound.  Photo:  Nevit DilmenGynecologists prefer the pelvic ultrasound for examining the uterus and ovaries. It is one of the more affordable diagnostic imaging exams, and it is the safest. In fact, ultrasound has no known harmful effects on the body.

Ultrasound is typically done for pelvic pain or abnormal bleeding. One may have excessive cramping, very heavy periods, spotting or bleeding between periods, or perhaps no menstruation, at all! The following are common findings on pelvic ultrasound.

Fibroids

Fibroids are muscular tumors within the uterus. Intramural fibroids are especially common, and can range in size from a few millimeters to the size of a grapefruit.


Subserosal fibroids affect the outer lining of the uterus. They may begin as intramural fibroids—of the middle, muscular layer of the uterus—that grow into the outer wall, pushing on it, or they may originate in the outer wall. Some subserosal fibroids grow off of the uterus kind of like a dog ear. These are called pedunculated fibroids. Fibroids that either push on the endometrium—the inner lining of the uterus—or originate from the endometrium are called submucosal fibroids.

Any type of fibroid may cause cramping, especially during menstruation. Fibroids that grow within, push on, or even lightly touch the endometrium may cause bleeding, from light spotting in between periods to long, heavy periods. Women who have a uterus that tips backwards—a normal positional variant—may experience lower back pain with fibroids.

Ovarian Cysts

The ovaries contain small, fluid-filled sacs called follicles. Throughout the menstrual cycle, one follicle grows to 1–2.5 centimeters in diameter, signifying that the egg within that follicle is maturing. This follicle will burst midway through the cycle releasing the egg into the fallopian tube. This is called ovulation. The burst follicle is called a corpus luteum cyst.

Both the follicle and the corpus luteum cyst can be seen on the ovary with ultrasound. The larger follicle may be described as a simple cyst, while the corpus luteum may be described as a complex cyst with increased blood flow around its perimeter. Physicians may order follow-up ultrasounds to see if these cysts clear up. Sometimes, a simple cyst may remain for months, and may grow very large. This often warrants surgery to remove the fluid within the cyst. More complex cysts that persist for long periods of time, or those with walls within the cyst, may be a sign of something more serious.

Polyps

Polyps are growths within the endometrium. These are often attached to a stalk that is filled with blood vessels. This can often be seen using ultrasound Doppler, a technology that shows the movement of blood cells. Since polyps are within the endometrium, they often cause unusual bleeding—sometimes light and spotty, sometimes heavy and clotty.

Polyps may be cancerous, so an endometrial biopsy and a hysterosonogram may be done. A sample of endometrial tissue is taken during the biopsy and sent to a lab to test for cancer cells.

The fallopian tubes cannot be seen with ultrasound. If there is an infection or an ectopic pregnancy within the fallopian tube, fluid may be seen within the tube. Ectopic pregnancies cannot always be seen on ultrasound, but are often visible around five or six weeks of gestation.

Pelvic ultrasound is often the first course of action in diagnosing gynecological conditions. It is relatively safe, does not threaten one’s fertility, and is incredibly useful in determining what needs to be done in terms of treatment or further diagnosis.



Comments

One Response to "Common Findings on Pelvic Ultrasound"

  1. Sequoyah says:

    what is endometriosis, And what is it caused from?

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