Almost every woman who comes to the obstetrics and gynecology department has done a gynecological B ultrasound. As a patient, I also want to know more about the details and want to know exactly what is said in the report, so that I can have a good idea and make a targeted consultation.
First of all, gynecological B ultrasound includes transvaginal/rectal and transabdominal two ways, that is, the yin ultrasound in everyone's mouth and the B ultrasound that holds urine. The most relevant part of the ultrasound report is actually two parts: ultrasound description and ultrasound prompt.
Let's take everyone together to analyze the gynecological ultrasound report to achieve the purpose of preliminary understanding.
1
What can Gynaecological B ultrasound see?
What can be seen in ultrasound is in the ultrasound description, that is, looking at the picture and writing words, and the observations of the ultrasonography and measurement are objectively described in words. Specific tests include three parts: uterus, appendages, and pelvic effusions.
womb
Generally includes location, size, morphology, echo, intimal thickness and echo, presence or absence of an intrauterine contraceptive ring, and cervical length.
Attachment section
Usually describe the size of the ovaries on both sides, when necessary, describe the growth of follicles, if you add a sentence "see the luteum-like structure" do not worry, this is normal formation after ovulation. If the ovaries become smaller after menopause or surgery, and intestinal gas disturbances, the ovaries are not detected. Under normal circumstances, ultrasound does not show the fallopian tubes.
Pelvic effusion
Usually describes the presence or absence of the effusion and the amount of it.
2
What do you think of the ultrasound results?
The final result of the current examination, that is, ultrasound indication, such as whether there is an abnormality, the possibility of a certain disease. Ultrasound cues are based on objective ultrasound descriptions, but this is partly influenced by the expertise and clinical experience of the ultrasound physician, in addition to the conclusions sometimes have relevant recommendations.
If no abnormalities are found, the conclusion is usually that "no significant abnormalities are seen in the uterus and double ovaries", indicating that no significant abnormalities are found on ultrasound. However, it does not include some minor lesions, such as cervical lesions that can only be diagnosed under a pathology microscope, and cannot be seen by ultrasound.
The diagnosis of the disease needs to be combined with a comprehensive diagnosis of medical history, physical examination, laboratory examination, imaging examination and pathological examination.
3
focus! What do you think of abnormal reports?
Here, we briefly list the typical manifestations of ultrasound of common gynecological diseases, and the order is to look at the ultrasound prompts first and then look at the ultrasound description.
1. Ultrasound suggests "uterine/cervical fibroids may be"
If we want to understand the specifics of fibroids, we can go to the ultrasound description about the uterus. There are general descriptions of low, low, or high echoes of the anterior, posterior, intramuscular (interskepital fibroids), and outward protrusions (subserosal fibroids) of the uterus\cervix, as well as size. This allows you to know exactly where and how big the fibroids are, which is very important for treatment. For example, fibroids clinging to the lining or compressing, protruding to the uterine cavity often cause increased menstrual flow or prolonged menstruation.
2. Ultrasound suggests that "adenomyosis may be possible"
At this time, the uterus is often full and enlarged, the muscle wall on one side is thickened, the echo is uneven, and there are often descriptions similar to fibroids for more limited adenomyosis, but its boundaries are not clear.
3. The thickness of the inner film is abnormal
First of all, it must be clear that the thickness of the inner membrane is related to the menstrual cycle and whether it is menopause, and the intima is thinner when it first comes to menstruation, generally about 2-7mm, and then gradually thickens, and can reach 14mm before the ovulation period and menstruation, so it should be combined with different periods. After menopause, the inner membrane generally does not exceed 4mm, otherwise the inner membrane is thickened. In addition to the thickness, the doctor will also look at whether the inner membrane is uniform.
4. Intrauterine cavity and/or intrauterical intra-cervical parenchymal (like) structure
The ultrasound description section describes the low, high echo, size, and blood flow signals displayed by color Doppler ultrasound, some of which may be endometrial polyps or submucosal fibroids. If intimal CA (cancer, cancer) is considered, its relationship to the muscle layer is described. Some uterine cavity mass does not describe the thickness of the intima because the normal intimal is not visible.
5. Ultrasound prompts cervical CA (ultrasound visible cancer)
In addition to describing its size, location, and blood supply, ultrasound will also describe whether it reaches the inner mouth of the cervix and whether the outer edge reaches the serous surface.
6. One side of the cyst, mixed block or parenchymal block is the source of the ovaries or the source of the fallopian tubes
Usually women of childbearing age, with no normal ovaries seen in the adnexal area, will have a description of the echo, size, and morphology of the corresponding side of the mass.
If cystic is generally benign, and the mass nature of mixed and solid, ultrasound prompts will have a part of the judgment about the possibility of benign and malignant. Some also require further testing or retesting on days 5 to 7 of menstruation.
If it is suggested to be of tubal or mesangial origin, the size, morphology, and echo of the mass are described after the ovarian size description on the corresponding side.
7. Pelvic effusion
In general, physiological circumstances, especially after ovulation, some women will have a small amount of fluid in the pelvic cavity, which is normal. Pelvic effusion if there is pelvic inflammation, pelvic effusion due to medical, malignant disease, or ovarian hyperstimulation, or intra-abdominal bleeding (gynecology is mainly ectopic pregnancy rupture, luteal rupture, etc.).
Of course, the ultrasound results are one of the means for clinicians to diagnose, and if necessary, doctors will recommend further examination, and pathological results are the ultimate basis for diagnosing the benign and malignant disease. Therefore, when you see that the B ultrasound reports abnormal conditions, remember to seek medical treatment in time.
An important part of gynecological ultrasound - ultrasound in early pregnancy, and so on.
Author: Zhao Fangui Department of Ultrasound Diagnosis
Editor: Li Miaoran