Ultrasonography and incidental ovarian pathology

Dimitrios Siassakos, Valentine Akande, Luciano G. Nardo
In: Ultrasonography in Reproductive Medicine and Infertility · 2010 · pp. 155–162 · doi:10.1017/cbo9780511776854.021 · W2598132193
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This paper describes the visualization of fibroids via transvaginal ultrasound and discusses their symptoms, impact on miscarriage, and treatment options like myolysis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This chapter in Ultrasonography in Reproductive Medicine and Infertility reviews how ultrasonography should be used to characterize incidental ovarian masses, emphasizing assessment of mass size in three dimensions, location, consistency, and border definition, and noting that both transvaginal and combined transabdominal-transvaginal approaches may be needed because they have different advantages. It highlights that follicular ovarian cysts are the most common cystic adnexal masses in reproductive-age women, while luteal cysts can be distinguished by peripheral Doppler blood flow and menstrual disturbances. It also discusses the added role of noninvasive 3D/volume ultrasonography in gynecologic assessment, including for timely diagnosis of serious pathology such as malignancy, though the text does not provide quantitative outcomes or specific diagnostic accuracy metrics. This paper is centrally about endometriosis and/or adenomyosis — it is a chapter-level discussion of incidental ovarian pathology within a larger imaging text that includes separate chapters on pelvic endometriosis and adenomyosis.

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Abstract

A transvaginal scan (TVS) is performed with an empty bladder using a curvilinear, multifrequency, endocavity transducer with a typical central frequency of 6.5MHz. A fibroid outline is usually well visualized by TVS, even in the very small lesion, because of the pseudocapsule. The mixed tissue make-up of the fibroid produces a heterogeneous echo pattern on an ultrasound scan and can be highly attenuating of the ultrasound beam in some lesions. The most common gynecological symptoms of fibroids are menorrhagia and dysmenorrhea and, when significantly enlarged, they can also cause compression of adjacent pelvic structures. Most studies that have examined the relationship between fibroids and miscarriage rates have looked predominantly at intramural fibroids, with few data available on impact of submucosal fibroids. Myolysis is ablation of a fibroid mass by use of radiofrequency (RF) electricity, cryoprobes or focused ultrasound.
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- Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index from Section 2: - Ultrasonography in infertility Published online by Cambridge University Press: 07 September 2011 Book contents - Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index The size of the mass in three dimensions, its location, consistency, and borders (well-/ill-defined) should be determined for a diagnostic approach to masses. Generally, most diagnoses can be made by transvaginal ultrasonography; however, a combination of transabdominal and transvaginal scan should be considered as they have different advantages and disadvantages. Follicular ovarian cysts comprise the most common cystic adnexal mass seen in women of reproductive age. Luteal cysts are characterized by peripheral blood flow at Doppler examination and menstrual disturbances. Recently three-dimensional (3D) or volume ultrasonography has been added to the gynecologic assessment armamentarium. The availability of noninvasive ultrasonography has resulted in improved care for infertile women. The ability to diagnose and decide on appropriate treatment is invaluable in helping women to achieve better fertility outcomes where identified pathology is detrimental, but also in improving patient well-being where this may be more serious, such as malignancy, and is dealt quickly. - Type - Chapter - Information - Ultrasonography in Reproductive Medicine and Infertility , pp. 155 - 162Publisher: Cambridge University PressPrint publication year: 2010 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - Ultrasonography and incidental ovarian pathology - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Ultrasonography and incidental ovarian pathology - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Ultrasonography and incidental ovarian pathology - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011

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