Shows ultrasound of the ovaries. Ultrasound examination of the uterus and ovaries - when and why. Causes of changes in the size of the ovaries

The ovaries are a paired organ of the female reproductive system, which is located in the pelvic area. It is here that a new human life is born, or rather, the egg matures. Subsequently, subject to successful fertilization, she will become an embryo, then a fetus and, finally, a newborn baby. The size of the ovaries in the norm in women can fluctuate, but significant deviations indicate the presence of various kinds of pathologies. The only way to be sure of this is to do an ultrasound.

Location. The ovaries are located in the abdominal cavity on either side of the uterus. Their location is rarely symmetrical and this is a variant of the norm.
The form. The ovaries are visible on ultrasound as two oval tonsils. In healthy women, they are slightly flattened.
Size - length, width, thickness, volume. The size of the ovaries in each woman is individual and throughout life they can change. In many ways, these parameters depend on age, hormonal levels, general health, the number of pregnancies and childbirth. In addition, the ovaries can shrink and enlarge depending on the day of the menstrual cycle. That is why, if any diseases are suspected, the doctor will most likely prescribe not one ultrasound examination, but several on different days of the cycle in order to track how their size changes.
Structure. The ovary consists of two layers: outer (cortical) and inner (cerebral). In the outer follicles mature, the number of which in the right and left ovaries may be different. On average, there are about 12 of them in each. If the number of follicles is less than 5, there is a pathological deviation on the face.
outer contours. Normally, the surface of the ovary should be bumpy, indicating the presence of follicles in the outer shell.
Echogenicity is the most important ultrasonic parameter, which indicates the ability of organ tissues to reflect high-frequency sound. It must be homogeneous, otherwise we can talk about the presence of inflammation.

Range of ovarian sizes in healthy women

The size of the ovaries in women of childbearing age can vary within the following limits:

length - from 20 to 37 mm;
width - from 18 to 30 mm;
thickness - from 16 to 22 mm;
volume - from 4 to 10 cubic meters. cm.

Ultrasound is a reliable and affordable method for diagnosing diseases of the reproductive system. During the examination, the doctor determines the various characteristics and sizes of the organ (uterus, cervix, ovaries). If deviations from the normal size of the uterus and ovaries are detected during ultrasound, an additional thorough examination should be carried out.

The norm of the size of the uterus on ultrasound

A woman is sent for an ultrasound of the uterus if there are relevant complaints:

Drawing, aching, constant pain in the lower abdomen;
Pain in the region of the sacral spine;
Pathological discharge;
Lack of menstruation (menstrual irregularities).

During the ultrasound, the specialist detects:

It must be borne in mind that the body of each woman is individual. Therefore, the size of the uterus may vary slightly for different representatives of the fair sex. In this regard, the limits of the norm vary somewhat.

It should be noted that the normal size of the uterus depends on:

No pregnancies;
Number of births;
The presence of abortions;
Postmenopause.

To begin with, consider the size of the uterus in women of reproductive age. If a woman has not had pregnancies, then the size of her body is smaller than that of those who have had abortions and childbirth.

The norms of the size of the uterus according to the results of ultrasound in women who have not had pregnancies:

If a woman had only abortions (there was no childbirth), then the sizes increase slightly:

In women who have given birth, the size of the uterus depends on the number of births:

In postmenopause, the size of the cervix and pelvis of the uterus decreases, depending on the duration of this period:

Reasons for the deviation of the size of the uterus from the norm

The uterus may increase or decrease. In addition to natural causes (changes in hormonal levels: pregnancy, postmenopause), there are also pathological causes.

The norm of the size of the ovaries on ultrasound

In an ultrasound examination, the condition of the ovaries is determined by the following criteria:

Dimensions (length, width, thickness);
The volume of the ovary. Normally, it ranges from 2 to 8 cubic centimeters;
Echogenicity is homogeneous in the absence of pathological processes;
The surface of the ovary should be smooth with small tubercles. In women of reproductive age, follicles from 4 to 6 millimeters are detected on the surface. One dominant follicle (up to 25 millimeters) will be determined.

The parameters of the ovaries depend on the day of the woman's cycle. It should also be noted that with age, the reproductive function of a woman fades. In this regard, the parameters of the ovaries change in a smaller direction.

The normal size of the ovaries according to the results of ultrasound in a healthy woman of childbearing age:

Length: 20 to 37 mm;
Width: 18 to 28 mm;
Thickness: up to 15 mm.

The parameters of the ovaries during ovulation change somewhat, or rather increase:

Length: 25 to 40 mm;
Width: 15 to 30 mm;
Thickness: 25 to 40 mm;
The volume can increase up to 15 cubic centimeters.

In postmenopausal women, the size of the ovary is much smaller:

Length: 18 to 25 mm;
Width: 12 to 15 mm;
Thickness: 9 to 12 mm;
Volume: 1.5 to 4 cubic centimeters.

Reasons for the deviation of the size of the ovaries from the norm

If an ultrasound scan reveals a significant increase in the ovary, then we can talk about the presence of such pathologies:

Ultrasound of the ovaries in women can also detect a decrease in the ovary. Particular attention should be given to such changes in women of childbearing age. In this case, premature menopause develops, that is, the woman's menstrual function gradually fades away. This can be observed in women from 35 to 40 years old.

Normal size of the ovaries and uterus in pregnant women

During pregnancy, a woman's internal genital organs undergo great changes. Namely, the uterus and ovaries.

The ovaries stop producing eggs during this period of time. But its dimensions increase, literally by a few millimeters. This is due to increased blood circulation in the pelvis. The uterus changes significantly. Its size increases as the fetus grows.

It should be noted that there are norms for the size of the uterus during pregnancy. If they are rejected, it is possible to suspect the pathology of pregnancy or the fetus, as well as to identify multiple pregnancies.

The height of the fundus of the uterus directly depends on the duration of pregnancy.

For example, if the gestational age is 12-13 weeks, then the height of the uterine fundus is 12-13 centimeters. At 37 - 38 weeks, the bottom of the uterus is under the ribs and compresses the diaphragm (bottom height: 36 - 37 centimeters). After that (from 38 to 40 weeks), the bottom of the organ begins to gradually sink. Thus, the body prepares for the upcoming birth.

Ultrasound examination of the reproductive system in women is one of the most accessible and accurate methods used both in emergency cases and for the routine diagnosis of most gynecological diseases, the detection of the ovum, the study of fetal development, the evaluation of the effectiveness of the treatment, and the detection of tumor formations. Features of ultrasound of the pelvic organs in women is the variability of the echographic pattern depending on age, phase of the menstrual cycle, obstetric history.

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Ultrasound of the reproductive organs in women

Ultrasound examination - the creation of images (echograms) by reflecting high-frequency sound waves from the organs, which are recorded by the sensor. The acoustic signal, passing through dense media, is almost completely reflected, forming white areas on the echogram. Looser fabrics partially reflect the waves, creating different shades of gray on the screen. Liquids and cavities absorb sound and are colored black in the image.

Indications and benefits

Ultrasound examination of the reproductive organs is used to:

diagnostics of pathologies both during routine examination and in urgent cases;
monitoring the effectiveness of treatment;
tracking the dynamics of changes;
screening examination, including at different stages of pregnancy;
conducting various internal manipulations (biopsy).

Advantages of the method, allowing its use in obstetrics and gynecology:

high information content;
non-invasiveness;
safety for both the woman and the fetus;
availability and low cost;
the possibility of multiple holding;
no contraindications.

Pelvic ultrasound in women usually examines the uterus, cervix, ovaries, Douglas pouch, and bladder. Additionally, vessels and lymph nodes located close to the reproductive organs are examined. According to the indications, clarifying imaging techniques (Dopplerography, echography with contrast) are used to assess not only the anatomical norm, but also the functional state of the organs.

Kinds

There are several ways to carry out an echographic examination of the reproductive organs:

1. Transabdominally (through the abdominal wall).
2. Transvaginally (by inserting a special sensor into the vagina).
3. Transrectal (through the rectum).

1-2 days before performing any type of echographic examination, it is necessary to exclude products that cause gas formation (legumes, cabbage, white bread, grapes, pears, dairy products, etc.). Before the procedure itself, it is advisable to empty the intestines and not eat. It is recommended to take a towel or wipes to clean the skin from a special gel after the examination.

Types and features of echographic examination of the reproductive organs:

Kinds	Indications and features	Preparation and holding	Precautionary measures
Transabdominal (TA)	Routine examination of the pelvic organs for the detection of pathologies. It is performed for all categories of patients (including children). Provides a wide view of the pelvic cavity. During pregnancy, it is carried out to study the fetus. Obesity, abdominal adhesions, and flatulence can sometimes affect ultrasound results.	An hour before the ultrasound, drink 1 liter of water without gas, do not empty the bladder before the procedure (a full bladder conducts sound waves better). During an obstetric examination - one hour before the procedure, drink 1-2 glasses of water	The procedure is safe
Transvaginal (TV)	Targeted examination of the uterus and appendages. Carried out to women who are sexually active. Do not apply to children. The advantage is a better and clearer image. The disadvantage is the limitation of the view of other areas of the small pelvis. The result of the study is not affected by obesity and adhesions, to a lesser extent, gases in the intestines. There is a risk of transmission of infection if the technique of processing the sensor and performing the procedure is incorrect	Does not require special training from a woman. The study is carried out with an empty bladder. Before use, the sensor is disinfected and a condom is put on its surface.	Tell your doctor if you are allergic to latex
Transrectal (TR)	In special cases, according to indications: in girls and women who are not sexually active to diagnose the pathology of the uterus and appendages; with volumetric formations of the uterine-rectal space, etc.	Carried out after a cleansing enema. Use a special sensor with a condom on	Warn the diagnostician if there is an allergy to latex

In special cases (with congenital infection of the vaginal opening in girls or during menopause, according to indications), a transperineal examination (through the perineum) can be performed.

There are clarifying methods for imaging the reproductive organs, which are used during ultrasound:

1. Dopplerography - an ultrasound mode in which the reflection of sound waves from moving objects (including blood through the vessels) is recorded. Allows you to determine the number of vascularization zones, the mosaic pattern of blood flow, as well as indicators of blood flow velocity. It is used to study neoplasms in the evaluation of the "mother-placenta-fetus" system.
2. Hysterography is a method of examining the uterus by introducing echo-negative contrast into its cavity. It is prescribed for suspected malignant gynecological diseases, to determine the cause of infertility, etc.

Dates

Ultrasound can be performed immediately after menstruation or 1-3 days before it starts, depending on the goal. In emergency cases, an ultrasound scan is also possible during menstruation. It should be noted that there are differences in the sensitivity of echography for various diseases. For greater reliability, it is necessary to conduct an examination on certain days of the cycle:

The interpretation of echograms is carried out on the basis of:

position of the organ and surrounding tissues;
its size;
contour evaluation: evenness, clarity;
echogenicity: hypoechogenicity, hyperechogenicity, anechogenicity;
sound conductivity: amplification or attenuation of the signal;
analysis of the internal structure of education: cystic, solid-cystic, solid.

In connection with the functional features of the female reproductive organs, only a specialist can give a conclusion on the results of an ultrasound scan - taking into account age, gynecological history, phase of the cycle and the intake of certain hormonal drugs.

Uterus

Specialists pay attention to the shape of the uterus, its contours and position in the small pelvis. The location of the uterus is determined by the angle between its body and the neck. Normally, it is deflected forward, this position is called anteflexio. Deviation back (retroflexio) is not considered a pathology, but a woman may have problems conceiving and bearing a fetus.

The size of the uterus on ultrasound can undergo significant changes depending on age, obstetric history and reproductive function at the moment. The choice of the type of ultrasound scan can also affect the measurement results and give slightly different readings in the same patient. On a TV scan, the uterus is rounder because it is not under pressure from a full bladder.

Measurement of the length and thickness of the uterus, the thickness of the endometrium

The myometrium of the uterus should be homogeneous. When studying the echostructure of the endometrium, it is necessary to take into account the phase of the cycle. For convenience, a double layer of the endometrium is measured using the concept of M-echo.

The table shows the indicators in the norm:

Index	Norm
The form	pear-shaped
Position	anteflexio - the uterus is rejected anteriorly; retroflexio - the uterus is tilted backwards
Contours of the uterus	Clear and even
Echostructure of the myometrium	Has a uniform structure. There may be fineness. There are 3 layers:
Echostructure of the myometrium	Internal (subendometrial) - is a thin hypoechoic band around the endometrium	Medium - the thickest, has an average echogenicity	External - has the appearance of anechoic and hypoechoic inclusions, separated from the middle layer by a zone of vascular plexus
Echostructure of the endometrium	Homogeneous structure, change in the thickness and echogenicity of the endometrium in different phases of the cycle: I phase - anechoic structure; Phase II - hyperechoic structure. The thickness of the M-echo in the postmenopausal period should not be more than 5 mm
	cycle days	Thickness of the endometrium, mm
	1 - 2	1 - 4
	3 – 4	1 - 4
	5 – 6	3 - 6
	8 – 10	6 - 10
	11 – 14	8 - 15
	15 – 18	10 - 16
	19 – 23	10 - 20
	24 – 28	10 - 17
Uterine dimensions:	Length, mm	Width, mm	Thickness, mm
Women who have not given birth	38 - 50	27 - 37	39 - 49
Pregnancy without childbirth	43 -55	32 - 42	41 - 51
After the first birth	45 - 57	34 - 44	45 - 55
After 2 or more births	49 - 65	39 - 49	50 - 60
Menopause up to 5 years ago	32 - 44	26 - 36	30 - 42
Menopause more than 5 years ago	28- 38	20 - 30	26 - 36
The structure of the cervix	Homogeneous
The size of the cervix (in postmenopause, the cervix does not decrease significantly)	Length, mm	Width, mm	Thickness, mm
	28 - 37	29 - 53	26 - 33
cervical canal	from 2 to 6 mm
Douglas space	Lack of fluid (the presence of a small amount of transudate is permissible only during the period of ovulation)

The size of the uterus in girls

In children and adolescents, the size of the uterus is compared with age norms:

Ultrasound to determine pregnancy and after childbirth

Ultrasound is a method for determining pregnancy in the early stages, as well as the ectopic location of the fetal egg. With a normal pregnancy, an ultrasound procedure must be performed in each trimester:

I trimester - up to 12 weeks - examination of the fetus to identify gross malformations;
II trimester - 16-20 weeks - assessment of fetal development;
II trimester - 32-34 weeks - examination of the fetus, preparation for childbirth.

After uncomplicated delivery, ultrasound is performed on the 2nd day transabdominally. Normally, a small amount of blood clots is detected, and then the involution of the size of the uterus is traced.

Echogenicity is average with echo-negative inclusions (from 5 to 7-8 foci) - follicles. Features of the follicles on different days of the cycle:

1. Day 8-9 - detection of a dominant follicle up to 15 mm in size. The remaining follicles undergo involution.
2. 10-14 days - ovulation - an increase in the dominant follicle up to 25 mm.
3. After 14 days - the formation of a corpus luteum at the site of a burst follicle.

Postmenopausal - follicles are not detected

The size of the ovaries in postmenopausal women decreases in the same way as the uterus:

The fallopian tubes

Normally, with transabdominal ultrasound, it is very difficult to detect the fallopian tubes. Unchanged tubes are well visualized with transvaginal ultrasound. If there is an inflammatory process or tubal pregnancy, the fallopian tubes become definable for transabdominal imaging.

Ultrasound can be helpful in diagnosing ovarian pathology. Consider the physiological changes in the ovary during the monthly cycle.

Normal anatomy and physiology of the ovaries

The sex glands of a woman, the right and left ovaries, are bean-shaped. Their size depends on the biological age: the average volume of the ovaries in girls before menarche is about 3 cm3, in menstruating women - 10 cm3, in postmenopausal women - 6 cm3.

The ovaries are located on the sides of the uterus. They are reinforced in their position by ligaments. The ovary is supplied with blood from two sources: the ovarian artery arising from the aorta and the ovarian branch of the uterine artery.

Every 4 weeks, a mature egg is released, ready for fertilization. Between immature eggs are intermediate cells that secrete the female sex hormone. Thus, the gonads produce reproductive cells and secrete sex hormones.

Click on pictures to enlarge.

A photo. If you cut the ovary and examine it at high magnification, you can see the medullary (medulla) and cortical (cortex) layers. Medullary layer The number of round resting cells along the outer edge of the cortex are the primary egg cells, or follicles. Each newborn girl has 2,000,000 of these follicles. Only 200-300 of them will mature and form a mature egg. In the first 10 years of a girl's life, the primary follicles remain at rest, and the formation of sex hormones occurs only in small quantities. With the onset of puberty, the size of the ovaries increases and intermediate cells begin to function, which secrete more sex hormone. By the end of the maturation period, mature, that is, eggs capable of fertilization, are formed.

A photo. The development of follicles occurs under the influence of pituitary gonadotropins - follicle-stimulating (FSH) and luteinizing (LH) hormones. FSH stimulates the development of follicles in the ovaries. Follicles that were at rest divide once, then another time. The last division is called the maturation division. It is of great importance for fertilization and inheritance of parental qualities. About 10 follicles mature each menstrual cycle. Accompanying cells grow around the egg. Some of them are adjacent to the egg, surrounding it, while others form a Graafian bubble, which is gradually filled with liquid. Only one Graafian vesicle becomes the dominant follicle and reaches a size of 2.0 to 2.5 cm. The vesicle squeezes to the surface of the ovary, its membrane becomes thinner and thinner, and one day it bursts. As the follicle matures, it releases estrogen, which stimulates the growth of the endometrium. Close to day 14 of the menstrual cycle, high estrogen levels in a negative feedback mechanism cause the pituitary gland to stop secreting FSH and start producing LH. Ovulation occurs 36 days after the LH surge.

A photo. The follicular phase of the cycle ends with ovulation. At ovulation, the mature egg and surrounding cells are shed into the abdominal cavity. A tentacle with fringed petals (oviduct funnel) is so close to the ovary that, under normal conditions, it catches every egg that is released. The former follicle turns into a corpus luteum. In the luteal phase of the cycle, LH secretion promotes the development of the corpus luteum. The corpus luteum secretes estrogens and progesterone, which stimulate changes in the uterine endometrium to support early pregnancy. If pregnancy does not occur, then within 9 days LH secretion stops, and a scar forms in place of the corpus luteum - a white body. When the corpus luteum persists for a long time, the overproduction of progesterone can delay menstruation or cause abnormal bleeding.

Normal ovaries on ultrasound

The ovaries are homogeneous in structure, isoechogenic in relation to the uterus and hypoechoic to intestinal loops. Due to the vessels, the medulla may be hyperechoic compared to the cortex. Anechogenic follicles are located in the cortical layer along the periphery. The dominant follicle usually reaches 2.0 to 2.8 cm.

Important!!! Simple ovarian cysts less than 3.0 cm are considered follicles.

A photo. A - A normal ovary has several anechoic follicles along the periphery. B - After menopause, the ovaries atrophy. They are devoid of follicles, they have reduced blood flow, so they are difficult to detect. Menopausal women may have small cysts or residual follicles. A simple cyst less than 1 cm in a menopausal woman can be ignored.

Ovarian volume for different ages

The volume of the ovaries is calculated using the ellipse formula: 0.5 x length x width x height

Changes in the ovary during the monthly cycle

A photo. A - Normal ovary on the 12th day of the cycle. The dominant follicle is large in diameter and several small ones (2-5 mm). Why does one follicle from a cohort develop while the rest undergo atresia? Mystery… B — Before ovulation, the wall of the dominant follicle has a developed network of thin vessels, the blood flow in the wall is increased. B — Atretic follicle of preovulatory diameter. Note the thin and flaccid, hyperechoic follicle wall. The wall of the atretic follicle is avascular. A large follicle is deformed due to small follicles along the periphery. With the growth of a healthy follicle, the increase in estradiol is significant, while the anovulatory follicle produces a minimum of estradiol.

A photo. Recording at the time of ovulation (time indicated at bottom left). It can be seen how the fluid releases the follicle, the walls close and two thickened slightly hypoechoic parallel stripes appear - this is the corpus luteum.

The corpus luteum is an endocrine gland that regulates the menstrual cycle and maintains early pregnancy. The corpus luteum is formed from the cells of the wall of the preovulatory follicle. After ovulation, the volume of the luteal tissue increases, there is an increased neoplasm of blood vessels, the level of progesterone and estradiol increases. High blood flow in the corpus luteum is an indicator of metabolic activity. The corpus luteum remains unchanged until the 12th week of pregnancy and until the 23rd day of the menstrual cycle if pregnancy does not occur.

The corpus luteum may fill with hypoechoic liquid contents, in which case it looks like a cyst. The fluid inside the corpus luteum must be interpreted as a normal physiological phenomenon. Most often, blood and ichor flow out of the vessels of the wall of the follicle after a rupture. Fluid can be seen immediately after ovulation, subsequently the volume may decrease or increase.

During the first week after ovulation, the corpus luteum can be traced to the point of rupture at the outer edge of the ovary. If the break point is not visible, it is difficult to distinguish between a corpus luteum cyst and an anovulatory follicle. Therefore, the best time to identify the corpus luteum is shortly after ovulation.

A photo. A - The corpus luteum without a cavity (arrow). B, C — Irregular corpus luteum with a thick, indented wall and hypoechoic liquid contents (asterisk).

A photo. Neovascularization of the corpus luteum begins immediately after evacuation of the follicular fluid. Within 48-72 hours, a vascular ring around the luteal tissue appears on ultrasound. As the corpus luteum develops, the ring of vascularization becomes more prominent. A, B - Blood flow around the corpus luteum on the day of ovulation. B - Blood flow around the mature corpus luteum.

The corpus luteum can be seen during the luteal phase of the menstrual cycle. At the onset of conception, the corpus luteum will remain the first trimester of pregnancy. In the absence of conception in the late luteal phase, degradation of blood flow begins in the corpus luteum, and with the onset of the next menstruation, the corpus luteum will regress. As a result of the regression of the corpus luteum of the previous cycle, a white body is formed. Sometimes you can observe several white bodies from previous menstrual cycles.

A photo. A, B - The white body is usually visualized as hyperechoic structures in the ovaries.

Take care of yourself, Your Diagnostician!

Ultrasound of the ovaries shows the shape, size, location of this paired organ. Thanks to ultrasound, it also became possible to visualize the follicular apparatus, that is, to get an indirect idea of a woman's fertility. This type of research can be carried out in several ways, each of them has its own characteristics of preparation. The description is carried out by the doctor on the basis of a comparison of the resulting data with normal parameters.

The normal size of the ovaries on ultrasound is as follows.

Ovarian parameters according to ultrasound diagnostics

In women 16-40 years old, the right and left ovaries should be approximately the same. They have dimensions: 30-41 mm in length, 20-31 mm in width, while the thickness of the organ is normally about 14-22 mm. The volume of each ovary is about 12 cubic milliliters.

The surface of the organ is bumpy due to the maturing tubercles-follicles. A fairly large number of blood vessels pass through the stroma. It has an average echogenicity comparable to the uterus.

The follicular apparatus is represented by approximately twelve maturing follicles (less than 5 in two organs - pathology) with a diameter of 3-8 mm.

In the middle of the cycle, a dominant follicle measuring 10-24 mm should be visible, then an egg should come out of it, and a corpus luteum is determined in the same place from the 12-14th day of the cycle (its work in size can be estimated on days 18-23) .

It rarely happens that ultrasound diagnostics of only the ovaries is carried out. Often, other reproductive organs of a woman are also examined in parallel, which is called a gynecological ultrasound.

Types of ultrasound diagnostics

An ultrasound examination of the ovaries can be performed in several ways:

Transabdominal, that is, when an ultrasonic sensor of a rather large width is located on the front wall of the abdomen. Previously, only this type of research was carried out. Now, with the advent of other methods, such an ultrasound is considered less informative, capable of visualizing only a gross pathology of the reproductive organs.
Transvaginal method of ultrasound diagnostics. It is carried out using a special sensor-transducer, which is inserted into the patient's vagina.
Transrectal examination is performed in virgins who need to diagnose a pathology that is not distinguishable by the abdominal probe. In this case, the transducer is inserted into the woman's rectum.

Ultrasound of the patency of the fallopian tubes is a separate type of study that can be performed by any of the above methods only when the uterus and tubes are filled with a special contrast agent.

How to prepare for the procedure

Preparation for the study depends on how the doctor plans to conduct this diagnosis:

Before the transabdominal examination, you will need to go on a diet for three days, excluding those foods that cause increased fermentation in the intestines (cabbage, legumes, carbonated drinks, brown bread). In addition, you are taking Espumizan or one of the sorbents (White Coal, Sorbex, activated carbon). An hour before the ultrasound, you drink 0.5-1 liters of water without gas, and then do not urinate.
A vaginal examination is performed after a 1-2-day intake of Espumizan or sorbents. The procedure is performed with an empty bladder.
For a transrectal examination, you will also need to take the above drugs, the bladder must also be empty. Half a day before the procedure, you will need to empty the rectum either on your own, or after: enemas, microclysters (such as Norgalax), the introduction of a glycerin suppository or taking a laxative (Senade, Guttalax).

By the way, pelvic ultrasound in women is performed exactly after the same preparation.

Timing of this study

The timing of when to do this procedure should be negotiated by the attending physician separately - depending on the objectives of the study.

So, a routine examination of the ovaries for their pathology is usually prescribed for 5-7 days of the cycle (that is, during menstruation or immediately after it). To assess the work of the organ, it is better to do the ultrasound examination procedure several times during one menstrual cycle: at 8-10, then 14-16, after - 22-24 days.

How the study is done

Since ultrasound diagnostics of the ovaries has several imaging methods, the examination will depend on which method you choose.

How is the transabdominal procedure done?

the patient undresses from the waist up
lies back on the couch
shifts underwear so that the suprapubic region is accessible to the transducer
gel is applied to the stomach
the sensor slides only along the wall of the abdomen.

Transvaginal examination

How does this type of diagnosis work?

a woman takes off her clothes below the waist, including underwear
lies on his back, bending his legs a little
a little gel is applied to the thin sensor, a condom is put on top
the sensor is inserted into the vagina to a shallow depth, this should not cause pain.

Study in virgins

How is transrectal diagnosis done? Just like a vaginal ultrasound, only the transducer in a condom is inserted into the rectum.

How to decrypt received data

The normal sizes of organs have been indicated above. The ovaries are located on both sides of the uterus, at its so-called ribs. The distance from them to the uterus can be different (decoding of pelvic ultrasound usually does not indicate such numbers).

Normally, the ovaries should not have cysts, that is, formations in which there is a cavity filled with fluid. There should also be no tumor-like or other formations.

If the ovary is not visible on ultrasound, this may be due to:

its congenital absence
removal during any celiac or gynecological surgery
premature organ exhaustion
severe distention of the intestines
severe adhesive disease of the small pelvis.

In this case, repeated thorough preparation is carried out with the obligatory intake of Espumizan or sorbents, only then a repeated ultrasound diagnosis is carried out.

Cystic formations - a norm or a pathology?

Sometimes, however, ultrasound describes an ovarian cyst. This is not always a bad thing, as there are cysts that form as a result of the work of the organ, which usually go away on their own, with a change in hormonal levels. Such formations are called functional or physiological. These include:

corpus luteum cyst
follicular cyst.

Other types of cysts - endometrioid, dermoid, cystadenoma, and so on - are considered pathological and are subject to mandatory treatment.

What an ovarian cyst looks like on ultrasound: as a liquid formation that has a diameter of 25 millimeters or more. You can also describe it as a ball that has a different structure and degree of coloring.

"Normal" cysts

1. A corpus luteum cyst (luteal) is formed in the place where the mature egg came out of the follicle. It has a diameter of 30 or more millimeters, often disappears spontaneously within one to several cycles if pregnancy does not occur. Such a cyst can accompany half of a woman's pregnancy, then disappear when the function of the corpus luteum to produce progesterone is completely taken over by the placenta.

2. A follicular cyst forms where the follicle matures. It grows from the first day of menstruation until the moment of ovulation, and can reach a diameter of up to 5 cm. Sometimes such a cyst ruptures, which causes severe pain in the abdomen and requires emergency surgery. Most often, this education passes by itself.

Pathological cysts and formations

There are not very many of them. Below we will look at the most common of them.

1. Dermoid cyst

A dermoid ovarian cyst is such a benign tumor that was formed as a result of a violation of intrauterine tissue differentiation. In her cavity are cells that should have formed the skin and its derivatives elsewhere, but ended up in the ovaries. As a result, the cavity of such a cyst is filled with nails, hair, cartilage.

On ultrasound, such a cyst has the following characteristics:

rounded formation
has thick walls (7-15 mm)
inside there are various hyperechoic blotches.

Sometimes, CT or MRI is necessary to clarify the diagnosis, since ultrasound diagnostics does not provide complete information.

2. Endometrioid cyst

Such a cyst appears in women suffering from endometriosis. It is formed from the tissues of the mucous membrane of the uterus, but in the ovary.

An endometrioid ovarian cyst on ultrasound has the following characteristics:

located on one side
single-chamber round or oval cavity filled with fluid
has different wall thickness (2-8 mm)
the outer contour is clear, even
internal can be both smooth and uneven
in the cavity there are echopositive inclusions less than 2 mm thick, which have an annular, arcuate or linear shape (“honeycombs”)
the ovary from the side of such a cyst is not differentiated
the uterus increases, as during pregnancy, but without changing its shape and structure
in a healthy ovary, small follicles are often found, often 2-3 dominant follicles mature in it.

3.Polycystic ovaries

This is a disease in which cysts have a completely different character from that described above. Diseases develop in young women and girls due to the increased formation of male sex hormones.

Polycystic ovaries on ultrasound looks like:

ovarian enlargement more than 10 cm 3
thickening of the organ capsule
they are determined by multiple cysts 2-9 mm in diameter.

4.Malignant formations

Ovarian cancer is a malignant tumor that appears most often in menopausal women, very rarely in young women, sometimes it is found in girls before the onset of the menstrual period.

Ovarian cancer on ultrasound is not always distinguishable from a cyst, especially of its type as a cystadenoma.

Cancer concerns should:

multilocular cyst
its spread to neighboring organs
incomprehensible contents of the cyst
fluid in the pelvic or abdominal cavity.

Usually, when such signs are detected, a woman is assigned a series of repeated ultrasound scans in dynamics. But if this description was made in a girl before the period of menstruation or a woman over 45 years old, the date of the biopsy is assigned.

Where to get tested

Ultrasound diagnostics can be passed both free of charge on the basis of a antenatal clinic or a maternity hospital, and for a fee - in multidisciplinary centers and specialized clinics.

The price of the study is from 800 to 1500 rubles.

Thus, ultrasound of the ovaries, subject to adequate preparation and the choice of an informative research method, is a fairly accurate method for diagnosing a wide range of pathologies of this organ. In some cases, in order to differentiate various pathological conditions, this examination should be carried out in dynamics.