Can You See Endometriosis on an Ultrasound?

While endometriosis can occasionally be shown on an ultrasound, it is not usually the case. The only method to get a solid diagnosis of endometriosis if your doctor suspects you have it is through laparoscopic surgery.

A gynaecological disorder called endometriosis causes cells that resemble the lining of the uterus to proliferate outside of the uterus.

The gold standard for endometriosis diagnosis confirmation has historically been surgery. However, this does not imply that endometriosis may only be found surgically.

Imaging techniques such as MRIs and ultrasounds can detect endometriosis growth in certain situations. An ultrasound is typically used in conjunction with early diagnosis.

Continue reading to find out more about the use of ultrasounds in endometriosis diagnosis.

Does endometriosis show up on an ultrasound?

Not always, but occasionally. An ultrasound may reveal endometriosis growths if they are sufficiently large. This identification enables medical professionals to establish a preliminary diagnosis.

However, a thorough diagnosis entails more than just imaging work. A thorough diagnosis of endometriosis entails determining the position, extent, and size of lesions in addition to evaluating the involvement of neighbouring organs and the existence of scar tissue.

It can be difficult to distinguish between endometriosis lesions and other structures, which is one of the main reasons why diagnosing endometriosis with ultrasonography is difficult.

Sonography, another name for ultrasound, is the use of sound waves to produce images of inside structures. The sound waves are transmitted into the body and then reflected by your tissues, producing an image or video that shows the structure and dimensions of your organs in real time.

Although detailed imaging can be produced by modern ultrasounds, their ability to distinguish between structures of similar densities or penetrate deeper tissues and cavities may be limited. Because of this, distinguishing endometriosis from other gynaecological disorders can be challenging. This implies that smaller, deeper lesions can go unnoticed.

A 2016 evaluation found that no diagnostic imaging technique was sufficiently precise to offer a thorough diagnosis of whole pelvic endometriosis. However, ultrasonography was thought to be a precise means by which surgeons might design focused surgical operations.

Ultrasound testing

Transvaginally (via the vaginal canal) and transabdominally (on the exterior of the abdomen) ultrasounds are performed for endometriosis.

The treatment doesn't require any preparation, and after it's finished, you can immediately return home. To help empty your system for greater image clarity, you might be requested to take a bowel preparation the night before.

You will be asked to empty your bladder, undress from the waist down, and cover your lower half with a gown or sheet before the ultrasound. With your legs spread apart and bent at the knees, lie on your back.

The technician will gently press against your abdomen with a handheld device coated in ultrasound gel. A vaginally inserted probe will be used if an internal ultrasound is required.

It's normal to experience pressure on your abdomen or during the vaginal canal insertion of the transducer. Although many facilities reheat the gel for comfort, it may seem chilly.

The transducer is spun gently and pushed against your skin at various angles to perform the ultrasound.

Doctors assess your uterus, fallopian tubes, ovaries, kidneys, bladder, and associated organs using this method. Their movement inside the abdomen and about each other, as well as any anomalies or soreness, are evaluated.

Other diagnostic tests

As of right now, endometriosis cannot be diagnosed in a lab setting.

The lack of trustworthy biomarkers for endometriosis diagnosis is the cause for this, per a 2023 diagnostic criteria proposal.

Tests can identify biomarkers, which are quantifiable signs of a disease such as protein, enzyme, hormone, or structural alterations levels. In essence, no blood test can detect endometriosis because there are no biomarkers for the condition.

Confirmation of the existence of endometrial lesions and associated scarring can still only be done visually.

Apart from ultrasound and surgery, magnetic resonance imaging (MRI) is a visual aid that can detect endometriosis. However, its display capabilities are still restricted, and it can also be more costly and time-consuming.

Questions to ask a doctor

You can better understand why and what to expect from an ultrasound by talking with a doctor before the procedure, even though it's thought of as a noninvasive medical treatment with very few hazards.

Asking a doctor the following questions is a good idea:
  • Who’s going to perform the ultrasound?
  • Will the ultrasound be both transabdominal and transvaginal?
  • Will you require several ultrasounds and visits?
  • Is there someone you can turn to for support?
  • What should I do the night before in preparation?
  • Before the ultrasound, have any current drugs changed?
  • What specific information is the ultrasound going to provide?
  • How long will the ultrasound take?
  • Based on your symptoms, what level of discomfort is expected?
  • Are there any risks?
  • After the ultrasound, should you anticipate any changes or negative effects?
  • Can you get the operation done if you are bleeding abnormally from your uterus, are pregnant, or are on your period?
  • How quickly are the findings available?

The bottom line

Although endometriosis can be seen by specialists on diagnostic imaging tests, including an ultrasound, surgery is still required to obtain a complete diagnosis.

While endometriosis can be confirmed to be present and located via ultrasound, smaller lesions or those located deeper within the abdomen may not be detectable by this method.

It might be difficult to differentiate endometriosis with ultrasound alone from other disorders that appear similarly. It serves as the main diagnostic tool at the moment.

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