Pelvic ultrasound is a non-invasive imaging technique that utilizes high-frequency sound waves to produce images of internal structures within the human body. It is primarily used for the diagnosis and treatment of gynecological, urological, and gastrointestinal diseases. The principle involves emitting sound waves through a probe and receiving echoes, which are then converted by a computer into two-dimensional or three-dimensional images. These images clearly display the morphology, size, and lesion locations of organs such as the uterus, ovaries, and bladder. This technology offers advantages such as real-time imaging, no radiation exposure, and repeatability, playing a crucial role in clinical diagnosis.
Pelvic ultrasound can be divided into diagnostic and therapeutic categories. Diagnostic ultrasound mainly observes anatomical structures, such as transabdominal or transvaginal scans. Therapeutic ultrasound combines focusing techniques (such as High-Intensity Focused Ultrasound, HIFU) to destroy diseased tissue through thermal or mechanical effects. Its mechanisms include converting sound wave energy into heat to induce coagulative necrosis of tissues or promoting microbubble oscillation to enhance drug delivery.
Diagnostic indications include gynecological conditions such as uterine fibroids, ovarian cysts, endometriosis, ectopic pregnancy, as well as urological issues like residual urine volume assessment and prostate enlargement. Therapeutic ultrasound is commonly used for non-invasive ablation of benign uterine fibroids, localized hyperthermia treatment for prostate cancer, or as an adjunct to targeted drug release in specific tissues.
Diagnostic examinations typically require the patient to have a full bladder, with the probe covered in gel and applied to the skin or inserted into the vagina. Therapeutic ultrasound adjustments depend on lesion depth and size, with frequencies usually ranging from 1-7 MHz and energy densities tailored accordingly. For example, treatment of uterine fibroids may involve 2-3 sessions, each delivering 1-3 Joules per square centimeter of sound energy, with real-time imaging monitoring temperature changes.
The risk of diagnostic ultrasound is extremely low, with possible temporary skin redness or swelling due to probe contact. Therapeutic ultrasound may cause localized pain, tissue edema, or short-term hematuria, with rare cases of tissue charring or nerve stimulation. Close monitoring of patient discomfort is essential.
Contraindications include:
Ultrasound complements radiological examinations (such as CT/MRI): ultrasound can quickly screen for lesions, followed by MRI for tissue characterization. Therapeutic ultrasound can be combined with chemotherapy, for example, using microbubbles to enhance drug penetration into tumors. However, concurrent use with anticoagulants should be avoided to prevent increased bleeding risks at the treatment site.
Diagnostic accuracy exceeds 90% in identifying uterine fibroids and is highly sensitive in differentiating benign from malignant ovarian cysts. Clinical studies on therapeutic ultrasound for benign uterine fibroids show symptom improvement rates of over 80% lasting more than two years, with post-operative complication rates lower than traditional surgery. Recent research also demonstrates its value in early ovarian cancer localization.
Alternative diagnostic methods include:
Therapeutic alternatives such as laparoscopic surgery can directly remove lesions but involve longer recovery and greater trauma.
It is recommended to avoid wearing metal jewelry or heavy clothing before the examination to reduce interference. If related to gynecological issues, a full bladder may be required, or fasting for several hours as instructed. Follow medical advice and inform healthcare providers of any allergies to gels or special medical history in advance.
Will the procedure cause pain or discomfort?Pelvic ultrasound is usually painless, but pressure from the probe on the abdomen or rectum may cause a sensation of compression. For transvaginal scans, specific positioning may cause brief discomfort. If severe pain or abnormal bleeding occurs, notify medical staff immediately.
Are there restrictions on daily activities after the examination?Most patients can resume normal activities immediately after the procedure. However, if invasive procedures such as transrectal or transvaginal scans are performed, strenuous activity may be advised against for several hours. Persistent bleeding, severe abdominal pain, or fever should prompt immediate medical attention.
How long does it take to receive the results of pelvic ultrasound?Preliminary images can be reviewed immediately during the exam, but detailed reports usually take 1-3 working days, analyzed by a specialist. For urgent diagnoses such as ectopic pregnancy, reports may be prioritized. Discuss results with your doctor as scheduled.
What factors affect the accuracy of pelvic ultrasound?Accuracy may be influenced by bladder fullness, patient body habitus, lesion location, and operator experience. Obesity or excessive intestinal gas can hinder image clarity, in which case alternative imaging such as MRI may be recommended. Regular technological upgrades and operator training can improve overall accuracy.
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