Ultrasound of the abdominal and pelvic organs. How to prepare for a pelvic ultrasound and deciphering the results for men and women. Indications for ultrasound of the pelvic organs

Modern medicine can offer many ways to examine the body. Some are more common, some are less common. But one irreplaceable thing will be discussed below.

This type of research is the most modern way to diagnose many diseases, identify pathological processes, inflammation in abdominal cavity or gynecology as well. This is the most accurate research method, highly informative and, most importantly, very accessible to a wide range of the population.

Ultrasound research is based on the phenomenon of echolocation. The principle is approximately the following: a signal is sent inside the body using the device, where it is reflected from internal organs and comes back. The device reads it and, thanks to the different acoustic properties of tissues, they can be identified.

What is it for?

Ultrasound of the pelvic organs is performed on everyone, regardless of age and gender. They do it in order to get to the bottom of the cause of blood in the urine, difficulty urinating (kidney examination); identify a malignant tumor; diagnose the condition of the rectum; to determine the causes of abdominal pain. The ovaries, uterus and appendages are also examined. With its help, pregnancy is confirmed and its timing is established. Examine the prostate gland. Determine the causes of infertility.

There are no contraindications for these studies.

Ultrasound of the pelvis. Preparation

No matter what day this examination is scheduled, it should not be done if a procedure using barium was already performed the day before. Preparation for ultrasound of the pelvic organs is generally simple. And it depends on the organ that will be examined. The procedure itself is quite easy and quick; no activity is required from the patient. It is enough for him to lie on the couch, on his back or on his side. It is necessary to expose the stomach or lower abdomen. The diagnostician will lubricate the sensor with a special gel and move the sensor over the abdomen, pressing lightly. Viewing of internal organs is carried out from different angles.

If there is inflammation in the area being examined, discomfort or pain may occur during the examination. Depending on the disease and the purpose of the examination, the ultrasound procedure will take from ten to twenty minutes.

Transabdominal ultrasound

This type of diagnosis will be carried out externally, through the abdominal cavity. A couple of days before the scheduled examination, you should follow a small diet. Eliminate foods that cause fermentation and gas formation. Limit yourself in taking herbal products, meat products, it is better to exclude dairy and carbonated drinks. Before the ultrasound, you need to empty your bowels. Before the procedure itself, the patient will be asked to drink enough a large number of water to keep your bladder well filled. If the study needs to be done urgently, then the liquid will be administered in a hospital setting through urinary catheter. The examination can be carried out either lying on your back or on your side.

Transrectal ultrasound

Diagnosis of diseases through the anus. For transrectal ultrasound of the pelvis, preparation consists of performing a cleansing enema. The day before you should exclude gas-forming products. The patient is positioned on his left side, and his legs will have to be bent at the knees. A thin transducer is inserted into the rectum, so the examination is a little painful.

Transvaginal ultrasound

Diagnosis will be performed vaginally. Ultrasound of the pelvis, preparation: for this three to four hours the patient will not be able to drink liquids and should have a bowel movement immediately before the procedure. The procedure is performed lying on your back, hips apart.

If it is necessary to find the cause of infertility, then it will be more informative to do a transvaginal ultrasound than a transabdominal one.

To conduct an ultrasound of the pelvic organs, special preparation is not expected if the woman has bleeding of unknown etiology, the presence acute pain. It is best to carry out the procedure with an empty intestine.

To conduct a pelvic ultrasound, preparation for a woman’s menstruation is not required, if any emergency indications for research. If the procedure is planned, then it is better to carry it out on the fifth or seventh day of the cycle.

Ultrasound and pregnancy

This type of diagnosis for expectant mothers is simply an irreplaceable procedure that will allow both the gynecologist and the youngest mother to control the entire course of pregnancy. Modern diagnostics allows us to identify possible disadvantages already on early stages, with the onset of pregnancy, identify the location of the embryo to exclude ectopic fertilization. Such a pregnancy can pose a threat to a woman’s health and life.

An ultrasound examination will show with high accuracy the location of the fertilized egg. Determine its age, judging by its size, and structural features. Already in the fifth or sixth week of pregnancy using ultrasound examination future mom will be able to hear her baby's heart beat. This not only evokes positive emotions in both parents, but also allows the doctor to verify the normal functioning of the fetus and its normal development.

To perform a pelvic ultrasound, no preparation is required during pregnancy. It is carried out at all stages of pregnancy.

During her pregnancy, the expectant mother will undergo ultrasound screening three times. First, for a period of ten to twelve weeks. A little later, at eighteen to twenty-two weeks. And the final one - already at twenty-eight to thirty-two weeks. The purpose of the study is to give comprehensive assessment the condition of the fetus, find out anatomical structure, correct and timely development of all organs and systems, assess growth parameters, exclude developmental defects.

Examination of pelvic organs and tissues using ultrasound is widely carried out in both women and men. Modern specialists All women over forty years of age are strongly advised to undergo this type of study and men over fifty years of age. This will allow you to timely diagnose problems with the reproductive organs, bladder, and kidneys, if you have any. Thereby speeding up treatment and prevention negative consequences. Early ultrasound diagnosis for the purpose of prevention is the key to your health and longevity.

Preparing for an abdominal ultrasound

• vegetables and fruits, especially fresh ones;
• dairy products;
• sweets;
• carbonated drinks;
• strong coffee and tea.

How is an abdominal ultrasound performed?

Ultrasound examination (ultrasound) is an informative, non-invasive, practically safe examination of human internal organs.

The main obstacle to performing an ultrasound is the presence of air. That's why the main task Preparation for an ultrasound examination is to remove all excess air from the intestines. Preparation for ultrasound is especially important for obese people, since fat is the second most important obstacle to ultrasound.

Preparation:

Diet:

For 2–3 days do not consume brown bread, milk, carbonated water and drinks, vegetables, fruits, juices, confectionery, and alcohol.

In the absence of contraindications, you can also take any enterosorbent (polysorb, polyphepan, " white coal", Enterosgel) in a standard dosage; it is also advisable to do a cleansing enema 1.5–2 hours before the study.

The study is carried out strictly on an empty stomach (at least 6, and preferably 12 hours after eating). For example, the pancreas in a living person is located behind the stomach, and when the stomach is full, it is practically invisible on ultrasound.

Ultrasound examination of the abdominal organs.

Ultrasound can be used to examine parenchymal organs, as well as hollow organs filled with fluid. In the abdominal cavity these include liver, gall bladder, pancreas and spleen, bile ducts. Kidneys anatomically located in the retroperitoneal space, but usually they are examined together with the above-mentioned abdominal organs.

The intestines and stomach are hollow organs in which air is almost always present, so it is extremely difficult to examine them. And although very good preparation of the patient for ultrasound allows partially examine the walls of the stomach and colon; these techniques are extremely complex, time-consuming and painful for patients (the colon is first completely emptied using siphon enemas and then filled with liquid). Therefore, to study the intestines they use a simpler and informative method- colonoscopy.

Ultrasound is performed with the patient lying on his back. Sometimes, to get a better picture, the doctor asks the patient to turn on his right or left side, take a deep breath, and hold his breath. Some patients with individual characteristics (for example, with a high position of the spleen) have to be examined while sitting or even standing.

During ultrasound, they evaluate dimensions liver, its position, shape, ability to transmit ultrasonic waves, structure, condition of blood vessels and bile ducts, presence of foreign inclusions(for example, stones), shape, condition of the walls, size of the gallbladder, its position, the condition of the bile, the presence of foreign inclusions, structure, shape, position, ability to transmit ultrasonic waves, the condition of the pancreatic duct are studied condition of the biliary tract (with measurement of their lumen), portal, inferior vena cava and splenic veins. The same scheme is used to evaluate pancreas, spleen, kidney. At the end of the study, evaluate general state top floor abdominal cavity.

Based on the results of the ultrasound, the doctor writes a research protocol with a conclusion.

Important note. We have all seen photographs of internal organs obtained using an ultrasound machine - an echogram. They are not the subject of study and are not commented on. and serve only as an additional, optional appendix to the ultrasound examination protocol.

The most common and safest research method is ultrasound diagnostics. You can use it to identify possible diseases and pathologies of internal organs and start treatment in a timely manner. Unlike other examination methods, ultrasound diagnostics has virtually no contraindications.

Thanks to ultrasound diagnostics of organs, it is possible to assess the condition reproductive system women and identify possible pathologies.

An examination is prescribed for the following symptoms and diseases:

• Painful sensations in groin area and lower back.
• Pain during or difficulty emptying the bladder.
• Blood clots or mucus in the urine.
• Violation menstrual cycle.
• Inflammation of the genital organs.
• Gynecological inflammatory diseases.

In addition, an ultrasound is required to confirm pregnancy if there was a difficult birth or abortion, during surgery on the uterus and appendages, or when installing an intrauterine device.

Ultrasound is prescribed to exclude ectopic pregnancy. If conception has occurred, then the control dates for ultrasound diagnostics are in the first trimester from 12 to 14 weeks, in the second from 20-24 weeks, and in the third from 30-32 weeks.

Ultrasound diagnostics pelvic surgery is performed not only for women, but also for men. Main indications for research in men:

• Problems with urination.
• Pathologies.
• Bladder diseases.

The examination can be prescribed for children and adolescents with deviations in the development of the genital organs, early or late puberty, etc.

More information about ultrasound of the pelvic organs can be found in the video:

Transvaginal ultrasound is not performed in case of heavy bleeding or in virgins. It is prohibited to perform it in the second and third trimester of pregnancy, as this can lead to uterine tone and provoke contractions.

Contraindications to rectal ultrasound examination are: the presence of cracks in the rectum, exacerbation of hemorrhoids, after rectal surgery.It should be remembered that ultrasound is not performed after the procedure. Distortion of results may occur due to the introduction of contrast agents. In this case, it is better to postpone the ultrasound for a while.

Preparation for the procedure

Preparation for the examination depends on the diagnostic method: through the vagina, abdominal wall and rectum. The doctor will tell you in advance about the chosen technique for performing an ultrasound of the pelvic organs.

It is necessary to prepare for an ultrasound if the examination will be carried out through the outer abdominal wall or through the intestine.

A few days before the transabdominal examination, you should:

• Eliminate foods that cause gas and bloating from your diet. Such products include: cabbage, legumes, bread, apples, grapes, milk, etc. For 3-4 days, it is advisable to eat porridge, lean meat, steamed vegetables, and omelettes.
• It is recommended to drink 1-2 days before the test Activated carbon which will help get rid of gases if dietary food did not help.
• You should not eat food the morning before the procedure. The last appointment should only be in the evening. For prevention purposes, it is necessary to do a cleansing enema in the evening. If you have persistent constipation, you must do an enema in the evening and in the morning before the test.
• An hour before the procedure, you need to drink 1-1.% liter of clean water to fill the bladder.

If a transvaginal ultrasound is performed, the bladder should be empty. The study can be carried out on any day. The procedure is not performed on menstruation days. The most informative results will be after an ultrasound scan after menstruation. You will need a condom for the test.

An ultrasound scan with a vaginal probe may be performed several times a month to determine the maturation of the follicles and assess the condition and functioning of the ovaries.

3 hours before performing a rectal ultrasound, it is necessary to do a cleansing enema. For this purpose, you can use 1.5 liters of water. room temperature or special drugs that cause bowel movements: Norgalax, Microlax, glycerin suppositories.

In case of pathology, infertility or erectile dysfunction, it is necessary to fill the bladder. The patient should drink 4 glasses of water one hour before the examination.

Features of the examination

There are several methods of ultrasound diagnostics of the pelvis:

• Transvaginal method. It is carried out using a vaginal sensor. The length of the sensor is about 12 cm, and its diameter is 3 cm. This research method allows you to determine pregnancy by early stages, diseases of the uterus and other gynecological problems. A transvaginal examination is carried out as follows: the woman takes off her clothes below the waist and lies down on the couch. Legs are bent at the knees and spread apart. The doctor who conducts the study puts a condom on the sensor and lubricates it with gel. A homogeneous gel acts as a conductor between the sensor and the body, thanks to which favorable conditions are created for the visibility of the organ being examined. Next, the sensor is inserted into the vagina and the organs are displayed on the screen. With careful and slow insertion of the transducer, unpleasant and painful sensations a woman shouldn't feel it. The duration of the procedure is no more than 5 minutes.
• Transabdominal method. This research method involves sending ultrasound waves through the abdominal wall. This method allows you to assess the condition of not only a specific organ, but also those located nearby. As a result, the doctor receives big picture pelvic organs, which allows you to make the correct diagnosis and decide on treatment tactics. Transabdominal ultrasound is performed while lying on your back. The doctor moves the sensor over the patient’s abdomen, examining the necessary organs. The gel is first applied to the skin.
• Transrectal method. This is a common way to examine the male genital organs. Thanks to the rectal method, it is possible to examine the bladder, prostate gland and seminal vesicles. It can be performed not only for men, but also for women. The patient takes off his underwear, lies on his left side and pulls his knees to his chest. Next, the doctor lubricates the sensor with a water-soluble gel and inserts it into the rectum. Unpleasant sensations the procedure does not call.

Explanation: norm and pathology in women

When examining the bladder, its walls should be uniform and the same thickness, about 2-4 mm. There should be no stones in the bladder cavity. If you suspect urolithiasis You can detect dark areas with regular and clear boundaries.

If there is thickening of the bladder wall, this may indicate tuberculous inflammation or hematoma. When the entire wall of the bladder thickens, cystitis and amyloidosis are diagnosed. Deviation from the norm may be due to blockage of the internal opening of the urethra with a stone or due to a neoplasm.

Vaginal ultrasound provides more accurate information about the condition of the female reproductive system.

In this case, you can find out the location, structure, size of the cervix and the condition of the fallopian tubes. A change in the condition of these organs leads to discharge, pain in the lower abdomen and other symptoms.

Normal examination results in women:

• Normally, the length of the uterus should be 40-75 mm, and the width should be between 45-60 mm. The contours of the uterus in women and the prostate gland in men should be clear and even, the echogenicity of these organs should be uniform.
• Depending on the menstrual cycle, the inner layer of the uterus has different thicknesses. In the first week of the cycle - 1-4 mm, in the second and third - 4-8 mm, and in the fourth - 8-16 mm.
• Normal values ​​of the cervix: length and width are about 20-30 mm, and the anteroposterior size is within 15-20 mm. The ovaries should have the same indicators.

Ultrasound can detect the following gynecological diseases:

• Uterine fibroids
• Chorionic carcinoma
• Polycystic ovary syndrome
• Abscess
• Neoplasms
• or pus in the pipe

If the echogenicity of the uterus is reduced and the organ is increased in size, then this indicates the development of myomatous nodes.With endometriosis, the echogenicity of the myometrium increases, and uterine bending is observed. Due to the increase in anteroposterior size, the uterus becomes rounded and the thickness of the walls is uneven; small endometrial nodes are present in the walls.

The diagnosis of polycystic ovary syndrome is made when the ovaries increase in size, as well as the presence of many small follicles.An ovarian cyst on ultrasound looks like a small round bubble. The size can range from a few millimeters to tens of centimeters.

Interpretation of ultrasound scanning in men, as in women, is carried out according to the following indicators: location, shape, size, structure of the genital organs and bladder.

Normally, the length of the prostate in men is 25-35 mm, the width is 25-40 mm, and the thickness is no more than 2 mm. The volume of the prostate is in the range of 20-27 cubic meters. see The bladder should be normal size and have the correct shape.

Normally, there should be no compaction or enlargement of the seminal vesicles. Their size is cross section should be 8-10 mm.

In men, ultrasound can detect the development of a tumor of the prostate, seminal vesicles or their inflammation.

When conducting an abdominal examination in men, the testicles should not be present, and fluid should not accumulate between them. Depending on age and lifestyle, the size of the genital organs will vary.

Ultrasound examination in gynecological practice is very widespread. What is the purpose of an abdominal pelvic ultrasound, what is required for this procedure. What results can the study show?

The essence of the procedure

An abdominal ultrasound of the pelvic organs is performed in cases where it is not possible to examine the internal genital organs using a transvaginal sensor. Such situations occur in the presence of a intact hymen or in pathologies that impede passage through the vagina.

Ultrasound is performed using a conventional abdominal probe. If certain rules are followed, the information content of this method is no lower than when using a transvaginal sensor.

The study is carried out using an abdominal sensor when it is not possible to use a transvaginal one

Indications

An abdominal pelvic ultrasound is prescribed in the following situations:

• suspicion of an inflammatory process in the uterine cavity or appendages;
• inflammatory diseases of the bladder;
• suspicion of ovarian cyst/cysts;
• inflammatory processes in kidney tissue;
• cystic formations and kidney tumors;
• kidney prolapse;
• determining the degree of uterine fibroids;
• diagnosis of endometriosis;
• confirmation of pregnancy.

If it is impossible to carry out a transvaginal examination, the solution to the situation is to use an abdominal sensor. In men, abdominal ultrasound can diagnose an adenoma or malignant tumors prostate.

Preparing for an ultrasound

To create better visibility and increase the effectiveness of the examination, the patient is asked to prepare in a certain way. What is the preparation?

1. Three days before the expected ultrasound, you should refrain from eating cabbage, rye bread, berries and fruits, and fresh baked goods. All of these foods can cause increased gas formation, as a result of which the intestinal loops swell and make visualization difficult.
2. On the eve of the study, you should take several Espumisan tablets and sorbents.
3. In the evening, a cleansing enema is done or a laxative is administered in suppositories.
4. Immediately before the ultrasound, the patient needs to drink at least a liter of water and refrain from visiting the toilet. When filled bladder the internal genital organs are visible much better.

One of the stages of preparation for an ultrasound is taking Espumisan - to reduce gas formation

Technique

Ultrasound diagnostics are carried out in a specially equipped room. The patient is asked to undress to the waist and lie down on the couch. The examination is usually performed in the supine position, but the doctor may suggest turning on your right or left side. A special gel conductor is applied to the skin of the abdomen. It improves the quality of the ultrasonic signal, which helps to increase information content. The doctor will then move an abdominal probe across the lower areas of the anterior abdominal wall. The ultrasound procedure is safe and painless.

The procedure usually lasts 10-15 minutes. After this, the diagnostician examines the data obtained and issues a conclusion. This conclusion is assessed by the attending physician and based on it he makes a diagnosis.

What can you see

At ultrasound examination you can see a variant of the norm and various variants of pathology.

1. Normal ultrasound picture of the pelvic organs- uterus correct form, of appropriate size, with sufficient thickness of muscle walls. The tubes are passable, and rounded formations are found at their distal ends - the ovaries. The endometrium is smooth, its thickness corresponds to the phase of the menstrual cycle.
2. Pregnancy is also a variant of the norm - in this case, an attached fertilized egg is found in the uterine cavity. The minimum number of ultrasound examinations during pregnancy is three.
3. Inflammation of the uterus and appendages- the endometrium is thick, loose, there are irregularities.
4. A polyp is a growth of the endometrium of various sizes and shapes.
5. Uterine fibroids are the presence of one or more nodes in the muscular wall, on the mucous membrane or on the serous membrane.
6. Pathology of the pipes - narrowing of the lumen, the presence of adhesions, twisting of the pipe. Availability in fallopian tube fertilized egg.

With the help of pelvic ultrasound, you can see many pathologies - for example, uterine fibroids

The information content of abdominal pelvic ultrasound reaches 90%. You can use this procedure at any time medical institution- by doctor's direction or at your own request.