The optimal time to do an ultrasound for uterine fibroids. Signs of uterine fibroids on ultrasound: how to identify them and not confuse them with cancer or other serious diseases Description of ultrasound for fibroids from a doctor

Ultrasound examination is a common method for diagnosing diseases and neoplasms. It is applicable for internal organs and soft tissues. Very often used in gynecology. Diagnosis of fibroids by ultrasound is the most common method prescribed by doctors. This is due to the fact that it is simple and quite informative.

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Features of the procedure

Ultrasound is an ultrasound examination, also called sonography. It allows you to examine organs and soft fabrics human using ultrasonic waves. The waves are supplied by a special sensor. Due to the different permeability of certain tissues by these waves, a contrast image of the organ is formed on the monitor screen of the ultrasound machine.

Myoma on ultrasound

By studying it, the doctor can conclude that there are neoplasms, and sometimes inflammatory processes. This is how the diagnosis is made. The information content and accuracy of the method are quite high. But sometimes it also depends on the qualifications of the specialist.

Methods

IN different cases can be used different ways carrying out ultrasound examination. This depends on the intended (or actual) location of the fibroids. The anatomy of the patient and her state of health are also important. Some other factors also influence the choice of method. Most often, fibroids are diagnosed on ultrasound in one of three ways.

Transabdominal

Diagnosis of fibroids by ultrasound in this way is carried out relatively rarely. This method involves a procedure using a large probe. It is placed on the abdominal cavity. That is, visualization occurs directly through the peritoneum. If there is a suspicion of formation in the uterine cavity, this method is preferable. It is also used for women who have not yet become sexually active.

Transabdominal method

In other cases it is not used. This is due to the fact that uterine fibroids are less visualized this way. The specialist may not notice it at all. Especially when it comes to small formations.

The method is also used for some other contraindications to transvaginal examination. It could be pregnancy mechanical damage vagina, infectious diseases, etc.

Transvaginal

During transvaginal examination, uterine fibroids are visualized differently. This method uses a different shaped sensor. It is smaller in size. This sensor is inserted directly into the vagina. Thus, the maximum approach of the radiation source to the organ under study is achieved. The accuracy and information content of this method is much higher.

The method is not used for infectious and inflammatory diseases. Also if the vaginal mucosa is damaged. The method is contraindicated during pregnancy. It can almost never be performed on girls who are not sexually active. However, as prescribed by a doctor, it can sometimes be prescribed in these cases.

Hysterography

A specific type of ultrasound examination of the uterus. It happens as follows:

A saline solution, a solution of glucose or furatsilin is injected into the uterine cavity;
Direct visualization is carried out using ultrasonic sensors.

There is no particular point in conducting such a study if a neoplasm is suspected. Based on the movement of the fluid introduced earlier, a conclusion can be drawn about the patency of the fallopian tubes. This only indirectly indicates the presence or absence of nodes.

More often, the method is used in the diagnosis of obstruction and infertility. If neoplasms are suspected, it is almost never prescribed.

Indications

Indications for ultrasound are characteristic features uterine fibroids. These are phenomena such as:

Pain in the lower abdomen during menstruation or without connection with the cycle;
Drawing and aching pain in the lower back;
The appearance of bloody discharge not during menstruation;
Increased blood loss during menstruation;
Irregularities of the menstrual cycle (more often - shortening, rarely - lengthening);
Enlargement of the abdomen due to the growth of the neoplasm itself.

Another indication for the study is increased symptoms with diagnosed fibroids. If the signs intensify or new manifestations appear in the clinical picture, it is necessary to conduct an extraordinary ultrasound. Since this may indicate an increase in the growth rate of the node, its necrosis, torsion of the leg, etc. All these conditions require immediate diagnosis and surgical intervention.

Contraindications

Despite the fact that ultrasound safe research, there are some contraindications and restrictions to its implementation.

In some cases, it is recommended to perform a transabdominal examination on an empty stomach;
Transabdominal examination should not be performed if there is increased gas formation;
Transvaginal examination is not performed on virgins;
Also, transvaginal ultrasound is not performed after some gynecological operations;
Transabdominal examination is complicated if there is inflammation on the skin, dermatological diseases, preventing close contact of the sensor with the skin.

In some cases, there may be other contraindications. The doctor will notify you about them.

Progress of the procedure

The procedure with the transabdominal method is carried out as follows:

The patient lies on her back;
A special gel is applied to her stomach to improve the conductivity of ultrasound;
The doctor moves the sensor across the lower abdomen.

During transvaginal examination, a condom is put on the sensor (to avoid infections). A conductive gel is applied to it. The sensor is inserted into the vagina. During a hysterographic examination, a diagnostic solution is first injected into the uterus.

When to do it?

When is it better to do an ultrasound for the most accurate and informative result? In general, the doctor sets a date for the procedure regardless of the menstrual cycle. At all stages, the probability of accurately diagnosing a tumor is equally high.

There is only one exception. This is a suspicion of a submucosal node. This one is located in the endometrium. Therefore, the study should be carried out during a period when the endometrium is hyperechoic. Such a study will be much more informative. It is possible to diagnose even the smallest node. The endometrium reaches this state on days 19-24 of the cycle.

Transvaginal examinations are not performed during menstruation. The exception is cases when there is an urgent need.

How often?

When to do an ultrasound for uterine fibroids? The answer to this question depends on how quickly it grows. Immediately after its detection, a hormone test is prescribed. After this, therapy is carried out. Typically, a repeat study is carried out six months later to assess the effectiveness of treatment. Further research is carried out every six months. Once it is determined that the tumor has stopped growing, ultrasound can be performed less frequently - once a year.

If treatment was not prescribed (for example, before menopause), then the procedure is repeated after 3-4 months. If the tumor does not grow, then the next one will be in six months. If it grows, then in another 3-4 months. If it is determined that the tumor is not growing, then the study can be carried out once a year. And after menopause - even less often (according to doctor’s testimony).

Myoma during pregnancy and ultrasound

Regular ultrasound examinations of uterine fibroids during pregnancy play a very important role. Since the level of estrogen in the blood increases during pregnancy, cells in the tissues of the uterus begin to actively divide. Because of this feature, fibroids may occur. In addition, existing fibroids often begin to grow. For this reason, timely ultrasound examinations very important during pregnancy.

Fibroids during pregnancy

Large neoplasms can significantly complicate the birth process. They cause bleeding during childbirth. They can also complicate the child’s passage through birth canal. Possible physical compression of the fetus. Impaired functioning of the placenta, and as a result – insufficient supply to the fetus nutrients. For this reason, it is necessary to conduct timely tumor studies during pregnancy.

Common mistakes

Although this method diagnosis is one of the most accurate; there is a possibility of error when making a diagnosis. In some cases, fibroids may be confused with other conditions or growths. This often does not depend on the qualifications of the doctor. The following are the most common errors:

Uniform enlargement of the uterus and fibroids. Women who have given birth quite often or recently may have an enlarged uterus. In some situations, this condition can be confused with fibroids. Also, such an error is possible in the presence of congenital developmental anomalies;
Intramural (muscular) nodes can be confused with dilated veins of the myometrium. In this case, to clarify the diagnosis, polypositional imaging is used, and sometimes color Doppler mapping is also performed. In the latter case, a characteristic blood flow is found in the vein, which is absent in the fibroid;
With ultrasound of uterine fibroids, sometimes a small subserous node can be confused with a large ovarian tumor. However, such inaccuracy is almost completely eliminated when the study is carried out using the transvaginal method;
A submucosal tumor can be confused with a polyp. To clarify the diagnosis, a thorough history is collected.

Despite possible mistakes In making a diagnosis, ultrasound is currently the main diagnostic criterion. It is not too complicated or expensive, and therefore is prescribed quite often.

Video

Myoma is a benign neoplasm of the muscular layer of the uterus and is one of the most common “female” diseases. Early detection of pathology is extremely important. If uterine fibroids are suspected, ultrasound diagnostics is the most informative, safe and exact method, able to quickly make a diagnosis and begin treatment in a timely manner.

All further information is given for informational purposes - you should not look for indications and symptoms on your own, this can be done by specialists with whom we cooperate.

Please note that this text was prepared without the support of our website.

You can consult a qualified doctor online at any time by asking your question. The candidate will readily answer your questions medical sciences, specialist in the treatment of uterine fibroids Dmitry Mikhailovich Lubnin and endovascular surgeon, leading specialist in EMA Boris Yurievich Bobrov.

Indications for ultrasound

Fibroids can be detected on ultrasound even in the initial stages, which is very important for the woman and the doctor, since a small tumor is easier to treat, which makes it possible to stop its growth. The development of a tumor is diagnosed during routine examinations or if a woman comes in regarding such unpleasant manifestations:

heavy menstrual bleeding;
long menstruation – more than 8 days;
severe pain during menstruation;
periodic pain in the lower abdomen, radiating to the lower back;
problems with urination and bowel movements;
at bloody discharge not during menstruation;
in case of inability to get pregnant and infertility;
after an abortion or spontaneous termination of pregnancy;
as prevention during planning of conception;
with pathological manifestations of menopause.

As a result of an ultrasound examination of uterine fibroids, another cause of malfunction in the functioning of the female reproductive system will be confirmed or determined.

If a diagnosis of fibroid is suspected, an ultrasound examination is prescribed without restrictions, since it is completely safe method. A referral for examination is issued by a gynecologist or a doctor leading the pregnancy.

Types of ultrasound for suspected fibroids

What is an ultrasound scan for uterine fibroids called and how do these types of examinations differ? Three methods are used to diagnose uterine tumors:

Transabdominal examination. Performed along the front wall abdominal cavity. It is prescribed for primary diagnosis in the examination of all pelvic organs to determine the exact location of the pathology. Such an ultrasound diagnosis of cervical fibroids and its body helps to find out the exact location of the tumor, its expected size at all stages.
Transvaginal examination. It is carried out through the vagina by placing a sensor there, the woman is in a gynecological chair. Thus, cervical fibroids are determined by ultrasound precisely by location, size and its effect on surrounding tissues and organs. This method is preferable in the initial stages of the disease, when the size of the tumors is small.
Ultrasound scan of the uterus. The most complex technique in which a probe-sensor is inserted into the uterus itself along with saline solution. This method is used extremely rarely, with the use of anesthesia to exclude painful sensations. Indications for ultrasound scanning are suspicion of submucous myoma, which is located next to the endometrium and cannot be determined by other methods. Performed on a gynecological chair.
Transrectal ultrasound is performed by inserting a probe through the rectum. It is used for teenage girls, virgins and women with heavy blood loss during menstruation. Performed on a table in a position - lying on your side.

The choice of which ultrasound is performed for uterine fibroids remains with the attending physician, based on the stage, location, size of the tumor, general condition patient, pregnancy or menopause, other parameters.

When and how many times is an ultrasound done for fibroids?

Taking into account all factors, the doctor decides on which day of the cycle to perform a pelvic ultrasound in women with fibroids. The optimal time to do an ultrasound for uterine fibroids is the first phase monthly cycle, at this time you can get the most reliable results. At the end of the first stage, the results are already distorted, since preparation for the next ovulation begins, and with it swelling of the uterine body; also, under the influence of the hormone progesterone, the myomatous tumor itself can increase in size, which will distort the result. In addition, the thickening endometrium forms folds that mask the tumor, and the diagnostician can also be confused by the enlarged corpus luteum or ovarian follicle.

What day of the cycle?

Optimal days when it is better to do an ultrasound for uterine fibroids:

3-5 days – the most accurate result;
5-7 days – exact indicators;
7-10 – only at hopeless situations, in case of emergency hospitalization;
after the 10th day of ultrasound, the conclusion of uterine fibroids is considered unreliable.

It is generally accepted practice that the exact size of fibroids and other neoplasms can only be determined by ultrasound diagnostics from the 3rd to the 7th day after the end of menstruation. The thin endometrium allows even very small myomatous nodes to be seen

If submucous myoma is suspected, another examination is prescribed on days 19-24 - an ultrasound scan of the uterus with a thickened endometrium allows one to accurately diagnose a tumor of this type. This pathology is extremely rare, so it is often not even mentioned in information articles.

To accurately determine on what day of the cycle to do a pelvic ultrasound for uterine fibroids, a woman must know the schedule of her menstruation and inform the doctor about it. It is advisable to keep records of this regularly, since the examination will have to be carried out repeatedly. Such information will help the treating doctor make precise appointments for an ultrasound scan of uterine fibroids - on what day to conduct the examination next.

If during planned gynecological examination the doctor suspects the presence of fibroids, the first ultrasound may be prescribed without taking into account the cycle - to confirm or deny the diagnosis. Already after the conclusion of the initial results, a subsequent, more accurate diagnosis will be prescribed.

How many times is the examination done?

This question also worries women: how often to do an ultrasound for uterine fibroids? The answer depends on determining the type of neoplasm. To monitor the stability and growth of fibroids, follow-up examination may be scheduled after 3-6 months.

If the doctor is sure that the fibroids are stable and are not increasing in size, it is enough to undergo diagnostics once a year. Treatment is conservative.

The picture of rapidly growing fibroids requires ultrasound examinations more often - once every 4-6 months, so as not to miss its uncontrolled, dangerous growth. More frequent examinations will not show growth dynamics. As a rule, uterine fibroids are recorded on an ultrasound in a photo in different planes, and then the images from several examinations are compared.

Preparing for an ultrasound examination

If an ultrasound scan of uterine fibroids is prescribed, how to prepare for it? It depends on what type of examination the doctor chooses.

During a transabdominal examination (through the abdomen), you must adhere to the following rules:

in 3 days go on a diet that excludes fatty foods, legumes, raw milk and fermented milk products, raw vegetables;
drink only clean water still, exclude coffee, juices, strong tea, alcohol;
take medications for gas formation (Espumizan or Smecta) a day, the last time - in the evening before the examination;
in the morning – light breakfast;
Mandatory - full filling of the bladder: drink at least 1 liter of still water 2-3 hours before and do not go to the toilet.

For a transvaginal examination (through the vagina), the preparation is as follows:

completely free bladder before the examination;
taking medications for gas formation during the day before diagnosis;
In the evening a cleansing enema should be given.

For transrectal ultrasound (through the rectum), the preparation is exactly the same as in the previous case, but another enema with cool water is performed immediately before the diagnosis. Or the doctor prescribes laxatives.

What does a fibroid look like on an ultrasound?

During the examination, the specialist determines the following indicators:

how much the uterus itself has changed, its size, structure and density;
determination of uterine tone (it may be increased);
size, type, location, configuration of myoma nodes;
stage of development of the neoplasm;
the presence of hypoechoic formations and various stripes;
definition of node contours;
the presence of other inclusions in neoplasms - cysts, calcifications, etc.

Based on the results of what is seen on the monitor, what uterine fibroids look like on ultrasound, the description is made using special tables, which provides fairly accurate and complete information about the pathology.

Ultrasound, as a diagnostic method, allows you to identify fibroids with nodes up to 1 cm in size, and in hard-to-reach locations - from 1.5 cm. They look like dark bulges.

Features of ultrasound for uterine fibroids in pregnant women

Uterine fibroids are not considered a contraindication for conception, pregnancy and childbirth. But nonetheless, fast growth neoplasms and their location close to the place where the placenta is attached can cause fetoplacental insufficiency and the threat of miscarriage

There is an opinion that a surge in hormonal activity during pregnancy causes a sharp increase in even previously stable fibroids. But this does not always happen and there is no point in worrying about it.

Determination of the presence of fibroids and the dynamics of its growth are determined during routine ultrasound examinations at 12-14, 22-24 and 32-34 weeks of pregnancy. And only if a sharp increase in nodes or deterioration in health is detected expectant mother, the appearance of bloody discharge, control ultrasound examinations can be carried out every 2-3 weeks, and the woman prepares in advance for a caesarean section.

Is it possible to perform an ultrasound on fibroids during menstruation?

IN in some cases– in case of sharp paroxysmal pain during menstruation, or very large blood loss, an ultrasound scan can also be prescribed during menstruation. Transabdomial diagnosis is most often prescribed. The result of such an examination requires confirmation in the first period of the cycle.

What to do if uterine fibroids are detected

Modern medicine has several methods of treating pathology. Traditional ways Yayoma cures are:

Conservative treatment - gives results in the earliest stages and small sizes of nodes (up to 3 cm). Indicated for women up to 30 years old. The active ingredient is ulipristal acetate, which blocks progesterone receptors. The course of treatment is quite long - it includes up to 4 cycles with breaks of up to 2 months.

Drug therapy for fibroids is a gentle method and is easily tolerated by patients, but the effectiveness cannot be called high even if all conditions are met. Average complete cure occurs in 60% of cases. In addition, relapses cannot be ruled out.

Surgical treatment involves physical removal of the fibroids, and in severe cases, the entire uterus. The advantage of the method is that there is a guarantee of getting rid of fibroids; relapse is unlikely (no more than 14%), and if the uterus is removed, it is excluded. But the disadvantages are also obvious: stress from anesthesia, traumatic effects, Negative consequences operations until a woman loses her ability to bear children. In any case, after myomectomy you will have to abstain from childbearing for at least six months (preferably a year).

Previously, among the disadvantages, cosmetic damage was noted - a noticeable scar in the intimate area. But now the operations open type(through an incision) are performed quite rarely. The standard is considered to be surgical intervention using laparoscopy - the fibroid is removed through a puncture, leaving only a barely noticeable mark on the patient’s body.

The UAE method (uterine artery embolization) is the most progressive and gentle way to solve the problem. Based on application special staff containing microscopic balls (emboli). The composition is injected into the uterine arteries with a catheter through a puncture on the thigh - no invasive invasion of the tissue is required, no scars are left.

Emboli block the fibroid vessels, forming a blood clot. Deprived of nutrition, fibroid cells die, turning into harmless scar tissue, which resolves over time.

The EMA method is safe for reproductive health women, therefore it is especially indicated for women and girls planning pregnancy.

In addition, the volume of blood loss during menstruation and its pain are reduced, and other positive effects are observed.

To prevent sad developments, women need to undergo regular gynecological examinations, and if detected alarming symptoms- Ultrasound of the uterus. Remember that only if the disease is detected in a timely manner is its effective treatment possible.

Bibliography

Bobrov B.Yu. Obstetrics and gynecology / Bobrov B.Yu., Alieva, A.A.-No. 5, 2004.-68 p.
Mikhalevich S.I. Overcoming infertility. Clinic, diagnosis, treatment. / Mikhalevich S.I. - Minsk: Medicine - 2002 – 234 p.
Kustarov V.N. Uterine fibroids / Kustarov V.N., Linde V.A., Aganezova N.V. - SPb.: Special. Lit -2001- 360 p.

Based on the diagnostic results, a decision is made on further treatment. An ultrasound shows an objective picture of the condition of the woman. reproductive system what damage was found in it.

Ultrasound of the uterus is prescribed for the following indications:

every six months - for preventive purposes;
if a woman is planning a pregnancy and needs to get a general picture of the condition of the appendages;
postpartum period (in order to exclude pathologies that often “attack” women after childbirth);
reaching the age of menopause (if fibroids are present, they may shrink and disappear from view, and later transform into uterine sarcoma);
period of puberty of a teenage girl (determine whether there are initial deviations - and they are possible due to poor ecology, increased stress factors, a number of genetic anomalies);
painful menstruation;
previous abortion or miscarriage;
excessive duration of menstruation (over 8-10 days);
cycle disruptions (including too short breaks between periods);
cramping pain in the lower abdomen and side;
nagging pain in the lower abdomen;
infertility;
spotting between periods of different cycles.

Also, ultrasound of the uterus is indicated three times for pregnant women (at the 12th, 23rd and 30th weeks).

How the procedure works

Ultrasound of uterine fibroids is not only the visual side of the matter. Great importance have the genetic characteristics of a woman, her sex life, past experience (problems and difficulties associated with the uterus).

Myoma behaves insidiously: initially it does not manifest itself in any way (according to statistics - in 85 cases out of a hundred). Moreover, even at serious stages, when the only way out is surgical intervention. And it, in turn, is dangerous female infertility after operation.

During the procedure, the specialist should pay attention to the following points:

increased size of the uterus;
uneven contours of the uterus;
the presence of rounded structures in the cavity or muscle layer;
location of fibroid nodes.

Survey

The doctor should clarify and the woman should be provided with reliable information:

about the beginning and nature of menstruation;
about whether the woman has had abortions in the past (and if so, in what quantity, any information about the consequences that took place);
about the number of births, what complications there were during childbirth;
Is there any information about fibroids in other women in the family?

The woman is expected to provide comprehensive information. The patient herself is also interested in this, because based on the results of the examination, it will be easier to prescribe the optimal treatment.

Visual inspection

Along with the survey, the doctor examines the skin and mucous membranes. Quite often, just above the pubis, palpation of the abdomen reveals an enlarged area. True, this symptom is not decisive - the presence of fibroids is possible even in the absence of its signs upon palpation.

Hardware ultrasound of the uterus

Transabdominal examination:

the scanning machine works through the abdomen;
there is no penetration into the vaginal cavity;
At the same time, not only the uterus, but also the appendages (ovaries) are examined;
For better signal passage, a special gel is used (applied to the lower abdomen and to the ultrasound-emitting sensor).

Transvaginal examination:

the equipment signal is more sensitive;
the result is more accurate;
the pelvic organs (in addition to the uterus) are also examined;
a small sensor penetrates the vaginal cavity.

Both procedure options are completely painless. Modern equipment allows:

study in detail the nature of blood flow inside the fibroids;
accurately determine the location of the tumor and its size;
get an objective picture.

Based on the results of the ultrasound, a decision is made on further measures. The challenge is to prevent degeneration benign tumor(which is fibroids) into malignant. In most cases, patients are prescribed histological examination(hysteroscopy) of fibroid nodes.

Hysteroscopy— a method of minimally invasive examination of the uterine cavity using a hysteroscope, followed by diagnostic and surgical procedures.

Hysteroscopy allows you to identify and eliminate intrauterine pathologies, remove foreign bodies, take a tissue biopsy, remove endometrial polyps. During the examination, surgical procedures are available to eliminate uterine causes of infertility - endometrial polyps, submucosal myomatous nodes, hyperplastic foci of the endometrium, intrauterine synechiae and septa.

It is also possible to recanalize the fallopian tubes and evaluate their mucous membrane down to the fimbrial region.

Preparing for an ultrasound examination of uterine fibroids

Preparatory measures depend on how the ultrasound is planned to be performed - transvaginally (through the vagina) or transabdominally (externally through the skin of the abdomen). And that's why:

the fact is that ultrasound waves pass through the air with difficulty, but through dense water - as well as possible;
Accordingly, in the second case, the resulting image of the internal organs will be of extremely high quality.

Based on this, the preparation is different:

when examining through the vagina, the bladder must be emptied (go to the toilet immediately before visiting the doctor);
during an external examination, you need to drink 1 liter of water 1.5-2 hours before the ultrasound (the bladder should be full until the end of the procedure).

Timing of ultrasound for uterine fibroids

The examination should be carried out at a certain period associated with the female menstrual cycle. Only if this condition is met will the result be as accurate as possible and give a complete picture of the objective picture.

Follicle growth

While the woman is in reproductive age, her menstrual cycle is the basis of the most important physiological phenomenon:

once during the cycle, a vesicle matures, containing an egg (such a vesicle is called a dominant follicle);
the uterine mucosa thickens;
it produces special substances to support the development of the fetus at the beginning of potentially possible pregnancy(which is programmed by nature once a month).

Endometrial thickness

For uterine fibroids, ultrasound should be done only in the first phase of the menstrual cycle. During this period, the thickness of the endometrium (inner mucous membrane of the uterus) becomes minimal. That is, if a woman has any pathologies (lumps), they will be easier to see than against the background of a thickened endometrium.

If the examination is carried out in the second phase, the endometrium will be a folded dense tissue - in it small nodules will be completely lost and will escape the field of view of even the most sensitive ultrasound equipment.

Optimal time

Ultrasound timing:

To monitor the condition of the thickness of the uterine muscle, in most cases, ultrasound is performed on days 5-7 of the menstrual cycle (it is counted from the first day that menstruation begins). The optimal time frame is 3-5 days, but in any case no later than 7-10 days;
to assess the dynamics of follicle maturation and the functioning of the ovaries, sometimes an ultrasound is performed three times throughout the entire menstrual cycle (approximately from the 8th to 10th, from the 14th to 16th and from the 22nd to 24th days of the cycle) .

In women with an unstable cycle, examination days may be much longer. Each situation is individual.

Possible diagnostic errors

Unfortunately, none diagnostic method is not without errors. The following factors can lead to erroneous interpretation of ultrasound results:

low qualification of a diagnostician (inability to correctly interpret images obtained during scanning);
non-compliance optimal timing performing an ultrasound.

There are cases when fibroids are mistaken for a uterine polyp or vice versa.

Differences between polyp and fibroid

is formed in the muscle of the uterus (that is, it consists of muscle tissue). It grows inside the uterine wall;
if it appears, it in no way disappears on its own - during reproductive age it only increases or, after menopause, decreases slightly;
in the early stages they are very small, but as they develop, they sometimes reach gigantic size- with an apple or even a watermelon;
there is a very high chance of transformation from a benign tumor to a malignant one.

develops on the endometrium (that is, it consists of the mucous tissue of the uterus). A polyp grows on the walls of the fallopian tubes or uterus. In shape, it is a formation on a clearly visible thin stalk;
polyps change their size, sometimes resolve (that is, disappear without a trace);
polyps in diameter usually range from 4 to 5 mm (extremely rarely reach 12-15 cm);
polyps do not carry cancer risks.

Why is diagnostic accuracy important?

The symptoms of polyps and fibroids are similar in many ways:

polyps and fibroids are approximately equally common;
both can cause vaginal bleeding in the postmenopausal period;
both involve issues of reproductive capacity.

True, large fibroids additionally cause a frequent urge to urinate (this is natural, since there is pressure on the bladder) - and polyps (see above) with their small sizes do not make themselves felt at all.

To avoid diagnostic errors, you need to be examined regularly. Many women are negligent about their health. But for preventive purposes, you need to undergo an ultrasound of the uterus and appendages at least once. If the slightest lumps are detected, the doctor will then prescribe repeated procedures. They will show the dynamics, establish the nature of the formations (polyp or fibroids).

Ultrasound scanning error

An ultrasound examination of the uterus does not guarantee a 100% result the first time. You need to understand that any tumor has an imperfect shape. A two-dimensional projection, especially a one-time projection, does not guarantee absolute accuracy.

That is, for example, if today an ultrasound showed dimensions of 26 mm, and in the next cycle 29 mm, this is not yet a reason to make a final conclusion about the uncontrolled growth of the formation. Taking into account measurement errors, you need to:

at a minimum, be examined several times and carefully study multiple pictures (obtained during scanning);
at least 1-2 times protium MRI (the three-dimensional image will show the shape of the fibroids in different projections).

The cost of examination with MRI equipment is many times higher. Therefore, they are resorted to only in cases where there is an alarming reason to clarify the result of an ultrasound scan.

Myoma (adenomyosis) is one of the frequent illnesses female genital area. It ranks 5th in frequency. There are two types of benign tumor. The first is leiomyoma growing from the muscle layer. The second is fibroma, which grows from two types of tissue - connective and muscle. It is also called mixed. The size of the tumor is usually indicated by weeks of pregnancy.

The causes of this pathology have not been precisely established. There are factors that contribute to the occurrence of the disease:

diagnostic curettage;
abortions;
hormonal disbalance;
chronic inflammation of the pelvic organs;
poor nutrition;
heredity.

Signs of the formation of myomatous nodes are:

The difficulty in diagnosing fibroids is that the initial stage of the disease does not manifest itself. The symptoms are not pronounced, and the woman can endure it for a long time. discomfort without knowing what they are connected to. The tumor is discovered accidentally during a medical examination.

Using the manual method, it is possible to suspect the presence of a nodular form of fibroids in the uterus, but then you need to be examined in more detail.

Known cases malignant degeneration fibroid tissue, so tumor growth must be monitored using an ultrasound or MRI machine.

Myomatous nodes - what types of examination are needed

To plan treatment, you need to undergo tests:

blood for hormones;
blood chemistry;
blood on if there is a suspicion of dangerous tissue degeneration, since a fast-growing fibroid may turn out to be a sarcoma;
tissue analysis for histological examination.

The most informative is the ultrasound method and magnetic resonance imaging.

During the initial examination, ultrasound is performed using the transabdominal method. This makes it possible to see the nodes formed in.
To clarify the diagnosis, a transvaginal examination may be recommended. The procedure is performed with a vaginal internal scanner.
An ultrasound scan, in which the sensor is placed inside the uterus, allows you to see the mucous membrane and the number of nodes that are located close to the endometrium.

Indications for ultrasound:

Decoding the readings of an ultra sound scanner makes it possible to:

Uterine fibroids are visible on ultrasound as a dark area. The more such spots on the monitor, the more tumors there are in the uterus.

The MRI method is more expensive, but it allows you to see the exact location of the fibroid, especially if there is more than one node and gynecological surgery is planned.

Timing of ultrasound examinations

Women undergo an ultrasound scan for uterine fibroids on days 5–7 of the cycle. This is due to the fact that the thickness of the endometrium these days is the smallest. Next, a gradual thickening of the mucosa occurs, and it will be more difficult to determine the presence of tumors. Small nodes are practically invisible. Therefore, it is possible to miss the onset of the disease.

Important! After the 10th day of the cycle, you cannot do an ultrasound for uterine fibroids. The exception is submucous fibroids, which are better visible when the endometrium is enlarged.

The second reason why examinations are not carried out in the second phase of the cycle is high level progesterone, which provokes an increase in tumors. In this case, the readings will be incorrect.

The process of preparing for an ultrasound examination is simple. Depending on the type of equipment in the health care facility, your doctor may recommend drinking more water and filling your bladder. Or vice versa - go to the toilet.

During transvaginal examination, there may be painful sensations Therefore, it is recommended to take sedatives or painkillers.

This type of examination has advantages:

has no contraindications;
you can prepare quickly;
the conclusion is issued immediately;
can be done often;
At the same time, it is possible to do an examination of all pelvic organs;
the diagnosis is confirmed with high probability.

The correct approach to diagnosis and following the doctor’s recommendations regarding the timing of the procedure increase the accuracy of the diagnosis.

Endometriosis – when to perform an ultrasound examination

Unlike diagnosing fibroids, the second phase of the cycle is more suitable for endometriosis, when the uterus prepares to shed the mucous layer.

The following facts indicate the presence of endometriosis:

uneven thickness of the walls of the uterus;
round shape of the organ;
increase in the size of the uterus;
in the muscle layer, the doctor will see areas with increased echogenicity.

Examination of the ovaries for the presence of cysts should also be carried out in the second half, as they gradually increase in size closer to menstruation.

Treatment for uterine fibroids

Types of treatment for uterine fibroids depend on:

on tumor size and growth rate;
how much does the tumor bleed?
is it dangerously located, how many nodes are there – one or several;
whether the woman plans to have children in the future;
what age is the patient?

Curettage - can it be done for fibroids, on what day?

Curettage of the uterine cavity is indicated in the following cases:

the body is weakened by constant bleeding, anemia develops;
cleaning the uterine cavity is necessary for cramping pain;
with accelerated tumor growth;
removal is recommended when the woman does not intend to become pregnant;
when a tumor negatively affects reproductive function women;
new nodes arise.

To remove submucosal formations in gynecology, hysteroscopy is most often used - surgical method, based on transmitting an image of the uterine cavity to a monitor and monitoring actions using a laparoscope. Can be used for young women.

Myomectomy is done on days 5–7 of the cycle. Earlier is not advisable, as menstruation interferes with visibility. Later is not good, because the endometrial layer thickens and bleeding may occur, which will have to be stopped during the operation.

Women are then advised to have their uterus removed, if present. a large number of myomatous foci. To avoid relapse. If the uterus is removed, a woman's periods stop, but hormone production continues, so replacement therapy no need to carry it out.

Drugs

From medical supplies hormonal agents are used to normalize the cycle. Help is provided by general strengthening agents - vitamins, immune stimulants, homeopathic medicines.

Diet

fiber;
nuts;
legumes;
berries - fresh or frozen;
vegetables fruits;
greens are a must.

Eating fish is necessary at least 3 times a week. Dairy products it is advisable to buy homemade ones (difference homemade milk from purchased raw materials). The menu should include dietary yogurts that are prepared at home. If you suffer from constipation, then curdled milk with dried fruits and bran will help eliminate it and improve bowel function. Descriptions of recipes can be found on any culinary forum.

conclusions

To recover, you need to be interested in the causes of the disease and do everything to eliminate them. Regular examinations by a gynecologist can eliminate the disease by initial stage, which will require much less strength and funds.

Video: On what day after menstruation is an ultrasound done?

Video: Ultrasound of the uterus

Video: ultrasound - pregnancy with uterine fibroids. Multinodular fibroids

Uterine fibroids are among the top five diseases of the female reproductive system. Most often, this benign tumor occurs in women after 40 years of age, but young women 20-30 years old are not immune from fibroids. One of the main methods for diagnosing this pathology is ultrasound. But in order to correctly make a diagnosis and adequately assess the size and location of myomatous nodes, ultrasound must be done on a strictly defined day of the menstrual cycle. A little preparation is also required depending on the type of procedure.

What are uterine fibroids?

Myoma is a benign tumor of the middle (muscular) layer of the uterus - the myometrium. A distinction is made between a tumor consisting exclusively of intramuscular fibers (leimomyoma) and a mixed tumor consisting of connective and muscle tissue (fibroma).

There are different data regarding the frequency of development of such tumors. In women over 40 years of age they appear in 40% of cases, in women aged 20-30 years - in 15-20% of cases. The most dangerous are fibroids that are diagnosed during pregnancy. When the tumor is large, it can lead to miscarriage or even provoke congenital anomaly fetus due to pressure on the uterus.

The exact causes of this gynecological pathology have not yet been found. The main risk factors that can lead to tumors are:

hormonal imbalance (imbalance of sex hormones);
the patient has a history of uterine inflammation;
previous gynecological operations (curettage, abortion, etc.);
genetic predisposition;
poor diet and frequent stress.

Indications for ultrasound

Uterine fibroids are a very insidious disease. She can for a long time develop without the slightest symptoms, and only random ultrasound can detect pathology. If the doctor suspects a tumor during a routine examination, he will set a specific date for an ultrasound.

But there are also specific signs that, taken together, clearly indicate leiomyoma or fibroma. These are heavy periods and bleeding in between, severe pain in the lower abdomen and radiating to the lower back. If the tumor has grown sufficiently, due to pressure on neighboring organs, problems with bowel movements and urination appear. The inability to conceive a baby is also one of the signs of a tumor in the uterus.

The treating gynecologist will definitely refer the patient for an ultrasound scan with suspected fibroids in the following symptoms and situations:

upon reaching menopause;
after a miscarriage or abortion;
with excessively painful periods;
if menstruation is very heavy and long (up to 8-10 days);
with nagging and cramping pain in the lower abdomen;
with bleeding throughout the entire cycle.

It’s also worth thinking about what day to do an ultrasound when planning a pregnancy, in order to rule out all possible pathologies. And also after childbirth. Doctors recommend preventive ultrasound during puberty to find out if there are any incipient abnormalities in women’s health.

Preparation and performance of ultrasound

When examining for the presence of a benign tumor in the uterus, three main ultrasound scanning methods are used.

Transabdominal, external, examination (carried out through the anterior abdominal wall).
Transvaginal, internal, examination (carried out using a sensor that is inserted into the vagina).
Ultrasound scan of the uterus. In this case, an ultrasound probe is inserted into the uterus and saline solution is added at the same time.

Only the doctor decides which diagnostic method to choose. Thus, transvaginal ultrasound is ideal for early stage diseases when myomatous nodes are quite small. Transabdominal scanning allows you to clearly determine the location of the tumor. A scan of the uterus is usually done when there is a suspicion of a submucosal tumor located as close as possible to the endometrium.

Minimal preparation is required for a gynecological ultrasound. If you have an external scan, you should drink 1.5 liters of water an hour and a half before the procedure to keep your bladder full. Before a transvaginal examination, on the contrary, you need to go to the toilet to empty your bladder.

Before an ultrasound scan of the uterus, the preparation is the same as before a transvaginal one. Sometimes the doctor advises the patient to take a sedative or pain reliever before the procedure to eliminate any possible slight discomfort.

How to choose a day for an ultrasound?

But the most main preparation to ultrasound in the presence of myomatous nodules is choosing the right time for the procedure.

Which days of the monthly cycle are best for ultrasound for myomatous tumor? Doctors are unanimous in this regard: the analysis should be done in the first half of the cycle, immediately after the end of menstruation. Ideal days are 3-5, but usually ultrasound is prescribed on 5-7. After the 10th day, an accurate diagnosis of a uterine tumor is no longer possible.

There are two reasons for this strict time frame.

The first is that in the initial phase of the cycle the endometrial layer is very thin, so even small nodes can be easily seen. Then the endometrial layer thickens, and by the end of the cycle even peculiar folds form. In them, the tumor easily hides from the sharp “gaze” of the ultrasound machine. In addition, during this period, an enlarged ovarian follicle or corpus luteum can be mistaken for a myomatous node.

The second reason is hormonal. In the luteal phase, the production of the hormone progesterone increases, which can provoke tumors of myomatous nodes. And when the nodes are enlarged, ultrasound gives an incorrect idea of their condition and location.

The only exception is submucous fibroids - it is sometimes recommended to do it on the 19-24th day. In this case, the thickened endometrium, on the contrary, helps to correctly diagnose the tumor.