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Abnormal uterus- Abnormal ovary, How to verify the image

polycystic ovarian pain

Abnormal uterus
Myomas (fibroids)


  • Myomas appear in various ways on ultrasound examination. Most will be seen as multiple, well defined,homogenous, hypoechogenic, nodular masses, either subserosal or interstitial. Older maymoas become hyperechogenicand some will develop a complex echo pattern as a result of central necrosis. There may be bright echoes from classification. Rapidely growing myomas, as may occur in pregnancy, may simulate hypoechogenic cysts.
  • myomas may also contain calcium, which can present as hyperechogenic structure with distal shadowing. Myomas are almost always multiple and frequently distort the normal contours and the endomaterial canal of the uterus.
  • Myomas can also originate in the cervical part of the uterus and may cause distortion or blockage of the cervical canal.


Developmental variants

A bicornuate uterus may be identified by the presence of two endomaterial canals or two uterine fundi on transverse scans. care must be taken not to confuse a bicornuate uterus with an adnexal mass. A double uterus has two endomaterial canals and two cervices. If there is an adnexal or other mass, there will be only one canal.

The clinical relevance of anatomical variants
The clinical relevance of anatomical variants!

The endometrium (lining of the uterus)

The normal pattern varies with the stage of the menstrual cycle. In the secretory phase
(at the beginning of the cycle) the endometrium appears thin and hypoechogenic. In the proliferative phase (mid-cycle) the central part of the endometrium becomes hypoechogenic and is surrounded by a hypoechogenic rim. During  the menstural phase the endometrian cavity becomes totally hyperechogenic and thickend owing to sloughing endometrial tissue and blood clots.

Imaging the Endometrium
Imaging the Endometrium
Abnormal ovary

The normal ovary is slightly less echogenic than the uterus and less homogenious because of the presence of small follicles , Identification in postmenopausal women can be difficult, particularly after the age of 50.

longitudinal scan: a normal ovary
longitudinal scan: a normal ovary
Ovarian cysts

A follicle is a physiological ovarian cyst which normally disappears during the second half of the menstural cycle. If the follicle falls to ruputure in mid-cycle, it will become a follicular cyst, which is one cause of  ovarian cysts; these may be over 3cm in diameter, Immediately after ruputure there may be a liitle fluid in the cul-de-sac.

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