With the continuous improvement of living standards, people are paying more and more attention to health. As an ultrasound doctor, I receive many gynecological patients every day. Whenever I inform patients of uterine fibroids, some of them do not know what uterine fibroids are? Is it benign or malignant? Should I have surgery? Wait for questions like this, then I will explain to you what uterine fibroids really are?
Uterine leiomyoma is a common disease of middle-aged women and the most common benign tumor of female genitals. The incidence rate of women over 35 years old accounts for about 40%. It is common in women aged 30 to 50 years old and rare in women under 20 years old. Its pathology and classification are as follows:
Pathology: Uterine leiomyoma is often seen, accounting for about 80%. Myoma forms a false capsule by surrounding muscle wall fibers. Microscopically, myoma is mainly composed of spindle smooth muscle cells and fibrous connective tissue.
Classification: Uterine fibroids are divided into uterine fibroids (about 90%) and cervical fibroids (about 10%) according to their growth sites. According to the relationship between fibroids and the uterine wall, they are divided into intramural fibroids (60% -70%), subserosal fibroids (about 20%), and submucosal fibroids (10% -15%).
Clinical symptoms: Most patients have no symptoms and are only detected during physical examinations. Some may experience the following symptoms.
1) Menstrual changes: Excessive menstrual flow and prolonged menstrual period are commonly seen in submucosal and intramural fibroids. The reason is that fibroids cause the volume of the uterus to expand, leading to an increase in endometrial area or thickening of the endometrium, which hinders uterine contractions.
2) Lower abdominal lump: Accidentally felt a lump in the lower abdomen, varying in size.
3) Compression symptoms: Fibroids can compress adjacent organs, causing compression symptoms such as frequent urination, constipation, etc.
4) Pain: Generally does not cause pain. Submucosal fibroids stimulate contractions and produce pain. In rare cases, infection or degeneration of fibroids can cause lower abdominal pain.
5) Infertility: 25-35% of patients suffer from infertility.
For uterine fibroids, ultrasound examination is widely recognized as the preferred method for diagnosing uterine fibroids, which can accurately observe the size, shape, and presence of fibroids in the uterus. The main ultrasound manifestations are as follows:
Ultrasound examination methods can be classified into transvaginal examination, transabdominal examination, and transrectal examination. Transvaginal ultrasound examination is preferred for sexual intercourse, and for uterine fibroids larger than 5cm, a combined transabdominal and transvaginal examination can be performed. Patients without sexual intercourse can undergo simultaneous transabdominal and transrectal scans to improve accuracy. Abdominal examination requires bladder filling.
Ultrasound manifestations of uterine fibroids in different parts
1. Intermural fibroids: Single uterine fibroids often have a weak echo nodule, while multiple uterine fibroids have abnormal uterine morphology and uneven uterine walls.
2. Submucosal fibroids: fibroids develop towards the surface of the uterine mucosa and protrude into the uterine cavity, accounting for 10% -15%. Submucosal fibroids can cause the uterine cavity to enlarge and deform, making it easier to form slender peduncles.
3. subserosal fibroids: fibroids develop towards the uterine serosal surface, protrude from the uterine surface, and are covered by the uterine serosal layer and a small amount of muscle wall.
Ultrasound manifestations of uterine fibroid degeneration
1. Vitreous degeneration: The most common, due to insufficient blood supply to the fibroid, some tissues undergo degeneration, and corresponding weak echo or hypoechoic liquid dark areas appear on the ultrasound, with posterior echo enhancement effect.
2. Cystic degeneration: secondary to hyaline degeneration, tissue liquefaction, and ultrasound showing hypoechoic liquid dark areas of varying sizes.
3. Fatty degeneration: occurs in chronic ischemia of fibroids, often in the late stage of hyaline degeneration, and is a manifestation of early calcification.
4. Calcification: Commonly seen in postmenopausal women with uterine fibroids. When there is marginal calcification, the ultrasound image shows a strong echo ring around the fibroid; Diffuse calcification is characterized by scattered or diffuse distribution of strong echogenic plaques within the tumor, followed by acoustic shadows.
5. Red degeneration, with a sudden and significant increase in the size of the tumor visible on the ultrasound image. The internal echo is clearly uneven in strength, and the vortex like structure is clearer or there are cysts of varying sizes, similar to liquefaction of fibroids. Local tenderness is evident during scanning.
6. Sarcoma like transformation: The incidence is low, and the ultrasound image shows irregular enlargement of the uterus, irregular edges of the fibroids, and uneven internal echoes.
Warm tips:
Regular ultrasound examination can detect uterine fibroids in a timely manner, which is conducive to actively cooperating with the doctor's treatment. Pay attention to keeping warm during menstruation and postpartum, and avoid the intake of hormone food. Obese people should reduce fat, control diet, reduce the incidence rate, develop healthy and regular living habits, and effectively prevent uterine fibroids.
Through the above expression, the problem in everyone's mind should be almost solved! So uterine fibroids are like this!