Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop from the muscle tissue of the uterus. These growths are extremely common, and an ultrasound is typically the first imaging tool used to assess their presence, size, and position. The primary purpose of the ultrasound report is to translate the visual findings into precise medical data. Understanding this report is the first step toward discussing appropriate management with a healthcare provider.
Essential Measurements and Descriptors
The ultrasound report quantifies the growths, providing a precise snapshot of their physical characteristics. Each identified fibroid is measured in three dimensions: length, width, and depth, often displayed in centimeters. These measurements allow calculation of the estimated volume, which is important for monitoring growth or determining the best treatment approach. The report also notes the total number of fibroids present, distinguishing between a single growth and multiple lesions (myomatosis).
The report details the fibroid’s internal structure using terms related to echogenicity, which describes how sound waves reflect off the tissue. A fibroid is described as hypoechoic if the tissue appears darker than the surrounding muscle, reflecting fewer sound waves. If the tissue looks mixed, it is called heterogeneous, which can indicate areas of degeneration within the growth.
A fibroid is sometimes noted as calcified, meaning it contains calcium deposits, a feature associated with older, stable fibroids. The report may include findings from a Doppler ultrasound, which assesses blood flow. A hypervascular fibroid has increased blood flow, which is a factor when considering treatments like uterine artery embolization.
Interpreting Fibroid Location and Type
The location of a fibroid within the uterine wall is a significant factor, as it largely determines the symptoms a person experiences and the possible treatment options. Reports use specific terminology to classify fibroids based on their position relative to the three layers of the uterus. The three main types are submucosal, intramural, and subserosal, which directly correspond to the inner lining, the muscular wall, and the outer surface, respectively.
Submucosal fibroids bulge into the uterine cavity and are strongly associated with heavy menstrual bleeding and potential fertility complications. Even small submucosal fibroids can cause significant issues due to their proximity to the lining. Intramural fibroids are embedded entirely within the muscular layer of the uterine wall.
These intramural growths can cause the uterus to enlarge, potentially leading to bulk symptoms such as pelvic pressure or pain. Subserosal fibroids develop on the outer surface of the uterus and grow outward. These typically do not affect menstrual bleeding but can press on adjacent organs like the bladder or rectum, resulting in urinary frequency or constipation.
A specialized type of subserosal fibroid is pedunculated, meaning it is attached to the outside of the uterus by a thin stalk. If this fibroid twists on its stalk, it can cause severe, acute pain. Recognizing these location-based classifications in the report is important for determining clinical urgency.
Using the Report to Determine Next Steps
The data collected in the ultrasound report—specifically the size, number, and location of the fibroids—forms the foundation for a clinical management plan. For many individuals, the report will support a decision of watchful waiting. This approach involves periodic follow-up ultrasounds to monitor the fibroids for significant growth or changes, as fibroids are benign and often shrink after menopause.
The report also helps connect a patient’s symptoms to the physical findings, confirming the cause of their discomfort. For instance, a report detailing a large intramural fibroid or a submucosal fibroid validates the patient’s complaints of pelvic pain or heavy bleeding. This correlation is a decisive factor in moving beyond watchful waiting.
If intervention is deemed necessary, the ultrasound findings guide the selection of a treatment pathway. A submucosal fibroid might be best treated with a hysteroscopic procedure. Conversely, a large, deeply embedded intramural fibroid may point toward surgical removal or minimally invasive options like uterine artery embolization. The details in the report serve as a map, allowing the healthcare team to tailor the most appropriate approach.