Imaging of Acquired Uterine Lesions

JOURNAL TITLE: Donald School Journal of Ultrasound in Obstetrics and Gynecology

Author
1. Emilija Petanovska Kostova
2. Zorancho Petanovski
ISSN
0973-614X
DOI
10.5005/jp-journals-10009-1946
Volume
16
Issue
4
Publishing Year
2022
Pages
6
Author Affiliations
    1. Center for Assisted Reproduction and In Vitro Fertilization, “First Private General Hospital–ReMedika”, Skopje, North Macedonia; Medical Faculty, University “GoceDelchev”, Shtip, North Macedonia
    1. Center for Assisted Reproduction and In Vitro Fertilization, “First Private General Hospital–ReMedika”, Skopje, North Macedonia
  • Article keywords
    Color Doppler sonography, Enhanced myometrial vascularity/arteriovenous malformation, Intrauterine adhesions (Asherman\'s syndrome), Nabothian cysts, The isthmocele, Transvaginal ultrasound, Three-dimensional ultrasonography

    Abstract

    In general, the group of acquired uterine lesions consists of enhanced myometrial vascularity (EMV)/arteriovenous malformation (AVM), the isthmocele, intrauterine adhesions (IUAs) (Asherman\'s syndrome), and nabothian cysts. Uterine AVMs can be congenital or acquired. These vascular lesions can cause severe hemorrhage that can be life-threatening for a woman, so it has been recently suggested that curettage should not be performed in a patient who presents with abnormal uterine bleeding after an abortion or a delivery when there is an ultrasound-detected hypervascular area with turbulent flow within the myometrium. Color Doppler sonography is the preferred method of diagnosing uterine EMV/AVMs. The isthmocele is a myometrial defect resembling a pouch on the anterior wall of the uterine isthmus over a previous cesarean scar. Transvaginal ultrasound (TVUS) is the initial and most usual method described to assess the integrity of the uterus wall in nonpregnant patients. IUAs are also known as intrauterine synechiae or endometrial sclerosis. The most common presentation of Asherman\'s syndrome is secondary infertility. Two-dimensional (2D)/three-dimensional (3D) TVUS is useful in measuring the thickness of the endometrial lining. Also, together with or without sonohysterography (injection of sterile saline into the uterine cavity) can show the adhesions that characteristically appear as “bridging bands” of tissue that distort the cavity. Nabothian cysts are a common occurrence on the cervix. These are retention cysts of the endocervical glands caused by chronic inflammation. 3D ultrasonography gives an excellent image and the possibility of detecting nabothian cysts.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved