The development of modern medical imaging technology enables the early detection and intervention of many common gynecological diseases. Among them, ultrasound examination plays an extremely important role in the diagnosis of gynecological diseases due to its non-invasive, safe, and convenient examination characteristics. Especially for common benign tumors such as uterine fibroids and ovarian cysts, ultrasound examination is almost the preferred screening and follow-up method. So, how did ultrasound detect these lesions? How does it determine the nature and development trend of lesions? This article will take you to explore the truth.
1、 Uterine leiomyoma
Uterine leiomyoma is a benign tumor formed by the proliferation of uterine smooth muscle cells, with a high incidence rate, which is mostly seen in women of childbearing age over 30 years old. Although most fibroids are benign and many patients may not have obvious symptoms, some fibroids may cause problems such as excessive menstruation, prolonged periods, abdominal lumps, compression symptoms, or infertility.
2、 How does ultrasound detect uterine fibroids?
Gynecological ultrasound examination usually uses transabdominal ultrasound (commonly known as "abdominal ultrasound") or transvaginal ultrasound ("vaginal ultrasound"). Compared to other methods, transvaginal ultrasound is more accurate in detecting and locating uterine fibroids due to its probe being closer to the uterus and resulting in higher image clarity.
Fibroids typically appear on ultrasound images as a deformation of the uterine contour, or as low echo or mixed echo masses with clear boundaries and uneven echoes within the uterine wall. According to their location, they can be divided into:
1. Intrauterine fibroids: the most common, located in the uterine muscle layer;
2. subserosal fibroids: protrude outward from the uterus, sometimes connected by a pedicle;
3. Submucosal fibroids: protrude into the uterine cavity, which can easily cause bleeding and infertility;
4. Cervical fibroids: located in the cervical area, relatively rare.
Ultrasound can not only detect fibroids, but also measure their size, quantity, location, and relationship with the uterine cavity and cervix, providing a basis for treatment decisions. Color Doppler ultrasound can also evaluate the blood flow of fibroids, determine their activity, and help distinguish between benign and malignant lesions (such as uterine sarcoma).
2、 Ovarian cyst
Ovarian cyst is a common cystic mass in the female ovary, especially in women of reproductive age. Most ovarian cysts are functional cysts (such as corpus luteum cysts and follicular cysts) that can naturally disappear with the menstrual cycle, but there are also some cysts that may develop into lesions that require intervention, and even a few may be manifestations of ovarian cancer.
3、 How does ultrasound detect ovarian cysts?
On ultrasound images, ovarian cysts often appear as hypoechoic (i.e. black) circular or elliptical areas within the ovary or adnexal region, with clear boundaries and uniform liquid components inside.
Ultrasound examination can help doctors evaluate multiple characteristics of cysts:
Size: cysts with a diameter exceeding 5 centimeters require regular follow-up;
Boundary: whether the boundary is regular and separated;
Content: Whether it is purely liquid, or whether there is a "liquid-solid mixture", nipple like protrusion, etc;
Blood flow condition: Use color Doppler to evaluate for abnormal blood flow;
Bilateral: Whether there are cysts on one or both sides.
Common cystic lesions include chocolate cysts (caused by endometriosis), serous or mucinous cystadenomas, polycystic ovaries, etc. Through ultrasound imaging features, doctors can preliminarily determine the nature of cysts and further clarify the diagnosis by combining medical history, tumor markers (such as CA125), etc.
3、 Why do we need to have regular ultrasound examinations?
Although most uterine fibroids and ovarian cysts are benign and do not immediately affect health, they have a certain degree of growth and variability. Regular ultrasound examination can:
1. Monitor changes in lesions, such as cyst enlargement, morphological changes, the appearance of blood flow or solid components;
2. Evaluate symptom correlation: help determine whether bleeding and pain are related to the lesion;
3. Guiding treatment strategies: such as whether surgery or medication intervention is needed;
4. Exclusion of malignant lesions: Early identification of potential malignant tumor possibilities.
Especially for perimenopausal women, those with menstrual abnormalities, or those with a family history of ovarian cancer, regular gynecological ultrasound examinations should be performed.
4、 What should be noted during ultrasound examination?
1. Drinking water before examination: Abdominal ultrasound usually requires bladder filling, so it is necessary to drink water in advance;
2. Transvaginal ultrasound preparation: suitable for married or sexually active women, generally without bladder filling;
3. Avoid checking during menstruation: If it is not an emergency, it is recommended to avoid checking during menstruation;
4. Bring previous examination reports: it helps doctors compare the trend of changes in lesions.
5、 Conclusion: Uterine fibroids and ovarian cysts are common but easily overlooked diseases in women. Ultrasound examination, as a non-invasive and accurate diagnostic method, is an essential tool for women's health management. Regardless of whether there are obvious symptoms, it is recommended that adult women undergo pelvic ultrasound examination regularly once a year to achieve early detection, diagnosis, and intervention, so that their health can be controlled by themselves.