Female pelvic ultrasound is a diagnostic method that displays the structure of the uterus, fallopian tubes, ovaries and cervix. Detects hyperplasia and uterine cancer, endometriosis, ectopic pregnancy, polycystic ovaries. When conducting a standard ultrasound, a two-dimensional mode is used. The study is performed transabdominal, transvaginal and combined.
Before female pelvic ultrasound, it is necessary to carry out preparatory measures, thanks to which the quality of visualization improves. The training plan includes individual doctor’s recommendations (cancellation of medications, prescription of laxatives, carminative agents), as well as general rules:
- Correction of nutrition. 2-3 days before the study, you should stop eating foods that increase the content of gases in the intestine. Drinks with gas, peas, beans, muffins, cabbage, apples, milk should be excluded.
- Compliance with the drinking regime. With transabdominal ultrasound, 40-60 minutes before the start of diagnosis, you need to drink about a liter of water, juice or tea. This creates an “acoustic window” – a bladder filled with water reflects ultrasound waves better.
Female pelvic ultrasound is performed using a transabdominal and transvaginal sensor, allows you to visualize the walls and cavity of the uterus, cervix, vagina, fallopian tubes, appendages and bladder. Dopplerography displays the nature of blood circulation and the functionality of the uterine and ovarian arteries. Normally, the length and width of the uterus are from 4 to 6 cm, the anteroposterior size is 2.7-4.9 cm. The myometrium is homogeneous, without inclusions. The width and length of the ovaries are from 2.3 to 4 cm, the volume is 1.5-2.5 cm, the echo structure is homogeneous, the contour is clear and uneven. According to the results of ultrasound, various diseases are detected, including:
- Congenital anomalies of the uterus. The ultrasound method reveals different types of abnormal development of the uterus. In the ultrasound picture, the uterus is irregular, completely or partially divided in two, curved, bicuspid. Depending on the nature of the changes, a two-horned or one-horned uterus, doubling of the organ, and the presence of a septum are diagnosed.
- Endometriosis. With endometriosis, the spread of the inner mucous membrane beyond the uterine cavity, thickening of the walls and an increase in the size of the uterus is determined. There may be cysts in the ovaries – hypoechoic foci.
- Uterine fibroids. The main sign of uterine fibroids is a myomatous node or nodes – foci of altered echogenicity. With the development of necrotic processes inside the tumor, echonegative zones are observed. The organ cavity is deformed.
- Ectopic pregnancy. The most common variant of ectopic pregnancy is tubal pregnancy, in which the fetus is detected in the lumen of the fallopian tube as a focus of increased echogenicity with increased blood circulation. The size of the uterus is enlarged, the endometrium is thickened.
- Cancer of the uterine body. A malignant tumor of the uterus of small size has an increased echogenicity, a homogeneous structure. With infiltrative growth of the neoplasm, the contour is uneven. Large and medium neoplasias are characterized by heterogeneity of the internal structure, high echogenicity, lack of clear contours.
- Ovarian cysts. Simple cystic ovarian formations are displayed as anechoic foci that do not have inclusions, larger than 30 mm in size. Hemorrhagic cysts have hyperechoic inclusions, tecalyutein cysts are multiple, differ in greater wall thickness. In PCOS, the ovaries are enlarged, the medulla is expanded, the capsule is of high echogenicity, anechoic areas are on the periphery. Yellow body cysts are anechoic formations with thick walls.
- Ovarian cancer. Echo-signs of malignant neoplasms of the ovaries – anechoic, rarely hypoechoic foci, irregular or rounded shape, having clear contours. It is not uncommon to find single or multiple partitions of various thicknesses, echogenic inclusions along the inner capsule of the neoplasm and on the partitions.
When making a diagnosis, the results of ultrasound examination are not used in isolation. To confirm the presence of the disease, the doctor analyzes the information obtained during the survey, gynecological examination, laboratory tests of blood and biopsy material.
Ultrasound is characterized by high accuracy and informative data, it is harmless, provides information about the current state of the reproductive organs, allows detecting diseases at an early stage. The disadvantages of the study include discomfort during the transvaginal procedure, in some cases – the inability to differentiate the type of neoplasm. Ultrasound has a low cost compared to other imaging methods such as CT and MRI.