Ultrasound manifestations of uterine polyps

Ultrasound manifestations of uterine polyps mainly include intrauterine hyperechoic or medium-echoic masses, regular shapes, clear boundaries, sparse or no internal blood flow signals, and may be accompanied by uterine effusion. Uterine polyps are usually caused by local endometrial hyperplasia, inflammatory stimulation, abnormal hormone levels, iatrogenic damage, genetic factors, etc., and can be diagnosed and treated through hysteroscopy, pathological biopsy, drug treatment, surgical treatment, etc.

1. Hyperechoic mass

In ultrasonography, uterine polyps mostly appear as hyperechoic or moderately echogenic masses in the uterine cavity, and the echo intensity is higher than that of the surrounding normal endometrial tissue. The internal echo of the polyp is uniform, the boundary with the endometrial myometrium is clear, and there are usually no infiltrative growth characteristics. High echo may be related to fibrous tissue hyperplasia and dense arrangement of glands in polyps, and needs to be differentiated from submucosal fibroids, intimal hyperplasia and other lesions.

2. Morphological rules

Uterine polyps are mostly oval or drop-shaped under ultrasound, with a narrow base and often attached to the side walls of the uterine cavity or the fundus. The surface is smooth without lobes, and the diameter is mostly in the range of 5-30 mm. Three-dimensional ultrasound can clearly display the three-dimensional shape of polyps, help evaluate the location and thickness of the pedicle of pedunculated polyps, and provide a basis for formulating surgical plans.

3. Clear boundaries

The polyps are clearly demarcated from the surrounding endometrium and surrounded by a hypoechoic halo, which is an important feature in identifying malignant lesions. Color Doppler showed occasional punctate blood flow signals around the polyps, but no rich vascular network. When the boundaries are blurred or jagged, you need to be alert to the possibility of endometrial cancer, and pathological examination should be used to confirm the diagnosis.

4. Blood flow signal is sparse

Power Doppler testing shows that most uterine polyps have sparse blood flow signals and high vascular resistance index. A few large polyps can have a single blood supply vessel in the pedicle, and the blood flow velocity is usually lower than 20 cm/second. If abundant and chaotic blood flow signals or low resistance spectrum are detected, the possibility of dysplasia or malignant transformation needs to be considered.

5. Accompanied by uterine effusion

Ultrasound in some patients with uterine polyps shows separation of the uterine cavity lines with echo-free areas, suggesting combined uterine effusion. The effusion may be caused by polyps blocking the cervical canal, leading to menstrual blood retention, or it may be associated with chronic endometritis. During the second half of the menstrual cycle, the effusion phenomenon is more obvious. At this time, attention should be paid to distinguishing it from fallopian tube effusion.

After uterine polyps are discovered, ultrasound should be reviewed regularly to monitor changes and avoid strenuous exercise that may cause the polyps to twist or fall off and bleed. Keep the perineum clean and reduce uterine cavity manipulation to reduce the risk of infection. The diet should be light, with an appropriate amount of high-quality protein and vitamins, and limit the intake of high-estrogen foods. If abnormal uterine bleeding or abdominal pain worsens, you need to seek medical attention promptly for hysteroscopic evaluation, and choose conservative treatment with drugs or hysteroscopic resection based on the size and symptoms of the polyps.