What is a parenchyma of increased echogenicity. Decryption of the ultrasound of the kidneys: dimensions, position, contours

09.07.2020

But if an increased echogenicity of the liver is observed on the ultrasound, it means that for specific reasons, pathological changes occur in it - from fat inclusions, scars, abscesses and to sharp viral hepatitis, tumors or cell destruction. The average bandwidth of a healthy liver allows sound waves to pass through the tissues of the organ.

What it is?

Echogenicity is a technical term used in echographs to designate the ability of organs to reflect sound waves.

The ultrasound apparatus converts sound waves, reflected from tissues with different acoustic density, into a picture that can be seen on the screen during the study. Knowing accurate data on the echogenicity of each organ, the doctor states an increase or decrease. The deviation from generally accepted parameters means that negative factors provoked diffuse changes in the structures and operation of the internal organs: kidneys, pancreas, intestines, spleen, stomach and liver. Ultrasound makes it possible to visualize organs, identify the disease and trace the dynamics.

When the echogenicity of the parenchyma is raised, it means that at the moment its fabrics differ from healthy. With an increase in or decrease in echogenicity, changing the uniformity of the structure or contours of the organ, the visiting inspection of the dubious zone is carried out. Decoding ultrasound gives a clear idea of \u200b\u200bthe status and diffuse changes in the liver parenchyma and the entire digestive system. Manipulation allows you to find out the doctor and the following questions:

what is the density and size of the organ;
homogeneous or inhomogeneous structure;
are there scars or nodes;
what is the concentration of metabolic products;
glisters infection;
are there any tumor education;
state (expansion or narrowing) blood vessels and biliary ducts;
formation of stones and veins;
is the increased echogenicity accompanied by increased lymph nodes.

Normal texture of the liver

The structure of the structure of the liver and its structure.

The liver is iron of external secretion, the most important unpaid organ of the human body that performs more than 500 functions. In this peculiar "laboratory" are carried out the most complex processes. It actively participates in digestion, producing the necessary volume of bile, cleanses blood from toxins and other poisonous substances accumulated by the body due to adverse ecology, improper nutrition and alcohol abuse.

Normally, the liver parenchyma is a homogeneous structure, permeated with many vascular and bile ducts.
The echostructure of the fabric as a whole is small and uniform. Anatomical liver location allows you to effectively practice ultrasound and collect the necessary data that make out the conclusions about normal operation or pathological deviations. It is on the right side, weighs from 1.2-1.5 kg, and it has a dark red color.

Causes of enhancement of liver echogenicity
Echogenic deviations - a signal indicating problems with the liver, which should not be ignored, because everything is interconnected in the body. Violations of the functioning of one body can lead to a violation of the work of other individual bodies and subsequently an unfavorable outcome in general. The reasons for increased echogenicity are reduced to the table:
Pathology Features
Chronic hepatitis The homogeneous structure of the liver, echogenicity is raised moderately.
Cirrhosis On the early stage Diseases liver is increased. In later stages, dystrophy appears with a decrease in size. Inhomogeneous, mosaic type structure. Mixed echogenicity, depending on the localization of the lesion focus.
Dystrophy and steatosis (fat infiltration) Moderate liver increase. Echogenicity is enhanced with an increase in the intensity of reflection of sound waves from fat inclusions in hepatic cells.
Chronic cholangit High echogenicity is observed (hyperachege), manifested in a saturated reflection of sound waves from the walls of extended bile ducts.
Alveocococcosis, opistorhoz (glider invasion) The on-screen picture shows the diffuse enhancement of echogenicity, the vagueness of invasive and healthy tissue, the mesh structure.
Abscess liver The initial stage of the emergence of the inflammatory process is represented by a small segment of low echogenicity, but as the abscess develops inhomogeneous echo abscess - or lowered or too elevated.
Sugar diabetes can disrupt the work of the organ.
Other factors:
Echogenic education (hematoma, hemangioma, adenoma).
Obesity or sharp weight drop.
Alcoholic fibrosis and sclerosis.
Intensive reception of drugs.

Symptoms of liver pathology, accompanied by an increase in echogenicity
In elevated echogenicity, there are external signs or certain symptoms, indicating a disadvantageous state of the liver and requiring immediate appeal to the doctor to clarify the reasons for their ailment. Some symptoms are usually characteristic of those diseases that cause changes in echogenicity:
frequent pains, tingling, cutting on the right side below the chest;
nausea or vomiting;
the jaggility of the skin;
digestive problems;
liver modification (increase, deformation) during palpation;
overweight or obesity;
emerging problems with the heart;
reduced immunity.

Diagnosis and treatment
If the ultrasound cannot immediately make a diagnosis of liver disease, each subsequent study is appointed by a specialist based on these previous procedures.

Biochemical blood test will help detect hepatitis and HIV markers.
When, according to the results of the ultrasound, the doctor sees that the echogenicity of the liver parenchyma is increased and a diffuse inhomogeneous structure is observed, additional diagnostic methods will be proposed. This will determine what the anomaly provoked. Held:
Blood chemistry. Need to clarify the data on the processes inside the liver, or to detect hepatitis or HIV markers.
Computer or magnetic resonance imaging. Confirm that the echogenicity of the liver is raised.
Biopsy. Allows you to identify or eliminate the neoplasm in a separate area if the local echogenicism is observed.

The final diagnosis is made by the set of medical examination data, general analyzes, patient complaints, liver ultrasound. Therapy is aimed at eliminating the disease that caused the increase in echogenicity. In the treatment of doctors apply the method of relief symptoms:
strong pains are removed by antispasmodics;
stagnation of hepatic ducts are removed with choleretic drugs;
with excess accumulations in the abdominal cavity, diuretics are prescribed.

To lead to normal and protect hepatic cells, hepatoprotectors are used, such as "Essentialy" and "Hep-Merz". To resume the normal operation of vessels and receipts nutrients Deagregants are prescribed to the body. If inflammation is present, the course of antibiotics is required. When diagnosing hepatitis or cirrhosis, the patient undergoes treatment, chosen by the doctor for each person individually.

Can the ultrasound of the kidneys? What if the results of the ultrasound kidneys are good, and in the analysis of urine, deviations were found from the norm?

Are there any kidney diseases that cannot be revealed by ultrasound?

In which cases it is necessary to combine ultrasound kidneys from the ultrasound of other organs?

Ultrasound kidneys and hearts with hypertension ( increased arterial pressure)
)

Where to do ultrasound kidneys?

The site provides reference information solely to familiarize yourself. Diagnosis and treatment of diseases must be under the supervision of a specialist. All drugs have contraindications. Consultation of a specialist is obligatory!

Urolithiasis disease ( ICD). Kidney stones on ultrasound

Urolithiasis occurs almost 5% of the population. Among the kidney disease, it is in second place after inflammatory diseases. Urolithiasis is a multifactoric disease, the greatest component of this disease lies in the feeding and daily human activity.

Urolithiasis is diagnosed with various methods, among which Ultrasound It is the main one. On the Ultrasound kidneys The stones of any size and chemical composition are clearly visible. Standard x-ray techniques renal studies ( excretory Urography) are not as informative. CT scan ( Kt.) and magnetic resonance tomography ( MRI) give excellent visualization of kidney stones and accompanying complications urolithiasisHowever, these methods are not so wide available as an ultrasound study.

Urolithiasis disease ( nephrolithiasis). Acute renal colic on ultrasound

Urolithiasis is a common disease. It implies the formation of stones in the urinary ways under the action of various factors.
Stones can be in all the departments of the urinary tract, in the kidneys, ureters and in the bladder. There are many reasons that lead to urolithiasis and the formation of kidney stones.

The causes of the formation of stones in the kidneys are:

changes in metabolism ( increase in calcium content, blood phosphates and primary urine);
endocrine disorders ( hyperfunction of parathyroid glands);
nutrition ( hypovitaminosis A, C);
saturation drinking water mineral salts;
long bedding and reduced physical activity;
congenital narrowing of lochs, ureters;
reduced tone of smooth musculature of Lohanok ( leads to urine delay);
inflammatory diseases of urinary tract ( pyelonephritis).

Urolithiasis is usually inconspicuous for humans. Human can long years Do not suspect the presence of stones in the kidneys. However, with a random displacement of the stones, a condition known as the sharp renal colic can occur. At the same time, severe sharp pain in the lumbar region occurs, which causes the patient to cause ambulance. Stone entering the narrow area of \u200b\u200bthe ureter leads to the complete blocking of urine outrage. The pain is caused by stretching the kidney capsule and the strong spasm of smooth muscles of the kidneys and ureters. Patient may appear nausea and vomiting. When a grapple-shaped pain in the lower back, the patient always conduct ultrasound kidneys urgently.

With acute renal colic, the following signs are always noted on the ultrasound:

expansion of a cup and laughter and ureterals;
an increase in kidney sizes;
hypo echogenic kidney parenchyma;
the presence of a rim of hypo echogenicity around the renal capsule ( appears due to swelling swelling);
stone in the form of a hypeachogenic structure.

Treatment acute renal colic Different depending on the size of the stone. With its small patient sizes treat medication. In this case, the dynamics of moving the stone is monitored by ultrasound. If the stone is large, and the patient's condition is severely resorted to the operation. Recently, the methods of remote crushing of stone through the skin with the help of ultrasound are successfully used.

Stones in the kidneys ( conductors, sand in the kidneys) on ultrasound

Often, urolithiasis is not manifested by obvious pain symptoms. In this case, it is revealed by chance when planned inspections or by some specific symptoms. These include the presence of blood in the urine, sanding of sand or small pieces of stones during urination. The dimensions of the depot of urine stones are from 2 millimeters to 1 centimeter. Sometimes patients can disturb stupid pain before moving stones.

Renal stones may contain different substances:

urates ( salts of uric acid);
oxalates;
phosphates;
cystine;
protein, etc.

Uzi is the best method of detecting kidney stones. An alternative diagnostic method is a kidney x-ray using contrast agents. However, this method requires more time and less informative. The fact is that not all stones are X-ray-repeat, some are not visible on x-ray. This applies to protein, cholesterol stones, stones consisting of urea and other species of concrections.

Renal stones may have dimensions from a few millimeters to very large, filling around the entire cup-glass system. Such large stones are called coral. "Dormant" kidney stones often lead to complications. The most common one is to attach a secondary infection ( pyelonephritis). The bias of the stone can lead to acute renal colic. Sometimes kidney stones lead to chronic renal failure and hydronephrosis. Therefore, when they are discovered on an ultrasound, the doctor always assigns treatment contributing to their destruction and disbelief.

Mikrolites in the kidneys ( microlithiaz) on ultrasound

Microlithiasis is initial manifestation Urolithiasis kidney disease. It consists in the formation of small-sized stones, from 2 to 3 millimeters. They are called microliths. It is such stones that a person can observe in the urine. Microliths are dangerous in that they serve as the basis for the formation of large-sized stones.

When sand appears in the urine ( stones of small sizes) Doctors recommend performing ultrasound. Using ultrasound research, you can detect kidney stones of any size, as they have high echogenicity. Microliths look like hyperheogenic rounded or elongated education. Sometimes they leave a hypo echoic acoustic shadow - a special kind of artifact.

Microlithiasis treatment does not imply operational intervention. It consists in compliance with a special diet, restricting salt consumption, high calcium products. It is also necessary to increase fluid consumption and increase physical activity.

Middle diathesis ( MKD) as a factor in the formation of kidney stones

In the development of urolithiasis, the hereditary features of the body play a certain role. They are manifested in excess accumulation in the body of certain substances. Such states are called diathesis. With ureny diathesis ( MKD) The content of uric acid in urine and blood increases. Such states serve as starting factors for the formation of kidney stones.

To diagnose such a predisposition, ultrasound research is unsuitable. The uricultural diathesis can be determined by analyzing the biochemical composition of urine and blood. To reduce the risk of rock formation of kidney, the doctor prescribes a special diet together with drugs regulating the metabolism.

Ultrasound kidneys in exchange disorders ( gout, diabetes mellitus, amyloidosis)

The kidneys is an organ excavation from the body of metabolic waste. However, the possibilities of the kidneys are limited. With different metabolic disorders, the concentration of certain substances in the body increases ( glucose, urinary acid). In this case, the kidneys cannot fully cope with their excretion, some of them settle in the kidneys, damaging this body.

Metabolic disorders are common in the modern world. In order to identify them in advance, preventive inspections are carried out, blood tests. Control over the way of life and a variety of used products is the basis for the treatment of exchange disorders. With the help of ultrasound research it is possible to only determine the degree of kidney damage.

Gouty kidney on ultrasound

Gout is a metabolic disorder in which purines, uric acid derivatives occur in the body. The gout occurs on average and older, more often in women. The gout is manifested by the damage to the kidneys and the joints by the deposits of uric acid. The gout diagnosis is made on the basis of blood test.

Normally, the concentration of uric acid in the blood is 0.40 mmol / l. Increased uric acid content is caused by its excessive production or insufficient elimination. 70% of uric acid is excreted by the kidneys, the rest - through the intestines and the skin. With a high content of uric acid in the blood of the kidney, it does not cope with its elimination. As a result, it is deposited in the form of crystals of uric acid in the kidneys. This leads to the formation of stones and inflammation of the kidney channels.

The ultrasonic picture of the kidneys during gout is found even before the development of clinical symptoms. It consists in point hyperechogenic structures in the kidney tissue. It is they who are crystals of uric acid. In the development of gout, there are changes characteristic of chronic pyelonephritis. The kidney is wrinkled, its brainstuff deforms.

The gout is successfully treated by taking anti-inflammatory drugs and a special diet, as a result of which the formation of uric acid is reduced. When goug is needed to observe a vegetarian diet, chicken, low-fat fish, eggs are allowed from meat.

Diabetes

Sugar diabetes is an endocrine disorder, in which the blood sugar level is almost always increased. Sugar diabetes is explained by absolute or relative insulin deficiency. At the same time, a person is forced to take substantive preparations for life.

The high level of blood sugar is toxic for kidney vessels. Normally does not contain glucose, it is completely absorbed back into the blood from the primary urine. However, at the concentration of glucose in the blood, more than 9 mmol / l is released with urine, since the kidney is not able to ensure the reverse absorption of such a large amount of sugar. At the same time, kidney vessels suffer. Sclerosis of vascular gloms, reducing renal filtering. This leads to a diabetic renal failure. Clinically damage to the kidneys during diabetes is accompanied by eduction, high pressure, the presence of protein in the urine.

Diagnosis of diabetes is not a problem. Typically, patients are aware of their disease. Because of this, they can take preventive measures, warning kidney damage under diabetes mellitus. At ultrasound, kidney changes in diabetes have their own characteristic features. They are noticeable even before the development of symptoms associated with the defeat of the kidneys.

Registered on the ultrasound initial kidney changes in diabetes mellitus include:

an increase in kidneys;
changing the ratio ratio, their rounding ( thickness becomes equal width of 6 - 7 centimeters);
an increase in the echogenicity of the kidneys.

Without the absence of control, sugar diabetes ultimately causes renal wrinkle ( nephroclerosis). This change is characteristic of many renal diseases. It occurs when the kidney fabric is death and its substitution on the connecting tissue.

Amyloidosis kidney on ultrasound

The amyloidosis of the kidneys is a rare disease associated with the formation of amyloid kidney fabric. Various diseases ( chronic infections, rheumatism) Provocate immune disorders, due to which cells begin to produce this protein-saccharium complex. Amilide is postponed as in the endothelium ( inner wall) vessels and collective tubules, which is developing chronic renal failure. Amyloidosis is usually manifested in old age.

Amyloidosis has no own characteristic symptoms. Over time, the patient is beginning to disturb swelling and high blood pressure. The urine detected protein. These manifestations are symptoms of chronic renal failure.

Unfortunately, the diagnosis of amyloidosis is a difficult task. Before the development of chronic renal failure, this disease is almost impossible to detect existing methods to date. With the help of high-quality equipment on the ultrasound of the kidneys, some signs that require additional confirmation are revealed. In the initial stage of the amyloidosis of the kidney increases, acquiring increased echogenicity on the ultrasound ( so-called big fat kidney). In the late stage of the kidney shrinks, replacing with a scar cloth. Such a kidney is called amyloid. On the ultrasound, it looks like a hyperechogenic formation of 6 - 7 cm in length, with an uneven loop without a clear boundary between the cortical and brainstant. Thus, the diagnosis of amyloidosis is usually late, so it is very important to conduct a prophylactic kidney examination.

Most often, patients with amyloidosis makes a diagnosis of chronic renal failure. For successful treatment, it is necessary to establish the correct cause of the disease, but it is possible only by biopsy ( fence piece of fabric) And its research under the microscope.

Kidney tumors on ultrasound

Kidney tumors make up about three percent of neoplasms of various localization. Big role In the development of tumors, hereditary factors play, as well as contact with carcinogenic substances. These include dyes, phenols, asbestos. A significant role in the formation of tumors is played by smoking, kidney injuries and overweight.

Kidney tumors are divided into two groups:

Benign education. These include hemangioma, angomiolipoma, oncocytoma, adenoma and others. Such tumors grow slowly, they are found randomly and usually do not lead to a disruption of renal functions.
Malignant tumors. Kidney cancer always develops from the epithelium. The cancer tumor germinates in neighboring tissues and vessels, gives metastases and causes a fatal outcome.

To diagnose tumors, computer or magnetic resonance imaging is the best way. The exact diagnosis is made only after biopsy and histological research. This diagnostic method implies a study under a microscope of a small section of tumor tissue, pre-taken with special needles. Only under the microscope, you can define those cells that form a tumor. After establishing the cellular structure of the tumor, you can choose the correct tactics of treatment.

Ultrasound is not a reliable diagnosis of kidney formations. Unfortunately, with the help of ultrasound research, the fact of the presence of a tumor can be established, but it is impossible to determine its benign or malignant character with confidence. There are difficulties in the distinction of the cyst of kidneys from tumors. However, there are quite faithful signs that are inherent only by malignant tumors.

Kidney cancer on ultrasound

Malignant tumors make up the overwhelming majority of kidney tumors ( 85% ). Kidney cancer develops from the epithelium of the renal parenchyma and is referred to as renal and cellular cancer. To determine the tactics of the treatment of kidney cancer uses TNM classification. It describes a malignant tumor in size, degree of damage to lymph nodes and the presence of metastases. Most often kidney cancer gives metastases in light, bones, liver.

By the criterion T ( lat. Tumor - Tumor) Malignant formations are divided into:

T1. - tumor up to 7 cm, located inside the kidney capsule;
T2. - tumor from 7 to 10 cm, bounded by the renal capsule;
T3. - a tumor penetrating the adrenal gland or in veins of kidneys;
T4. - Kidney tumor, propagating outside the aperture or penetrating into neighboring organs.

By the criterion N ( lat. Nodulus - knot) The following kidney cancer variants distinguish:

N0. - no lesion of regional lymph nodes;
N1 - amused 1 lymphatic node;
N2. - Numerous lesions of lymphatic nodes are observed.

By criterion M ( lat. Metastases - metastases) The following kidney cancer variants distinguish:

M0. - no metastases;
M1. - Detected metastases in remote organs.

Ultrasound is used to diagnose malignant tumors, but with small sizes of tumors, additional examination may be required. The connection of the tumor with renal veins or its distribution beyond the renal capsule indicates its malignancy.

The following points may be signs of malignant tumors on ultrasound:

rounded or oval shape with clear uneven boundaries;
hyperheogenic shade of education;
inside the kidneys can be hypo echogenic areas corresponding to the zones of necrosis or cystic decay;
deformation of the kidney contour, an increase in its size;
reducing the diameter and displacement of the cup-making system.

With malignant tumors, ultrasound with color doppler mapping is often used. With this study, it is possible to detect abundant blood flow in the tumor area. The speed of blood flow in the tumor vessels is higher than in an unchanged renal parenchym. Sometimes in the renal and lower hollow vein you can detect cellular clomes. They can lead to heart attack or metastasis.

Benign tumors of the kidneys on the ultrasound ( hemangioma, adenoma, oncoscitoma)

Benign tumors of the kidneys are diverse, but they look at about the same on the ultrasound. Some of them are safe, while others can become malignant ( for example, adenoma). Due to the fact that they require different tactics of treatment, it is very important to establish the origin of the tumor. Ultrasound examination for this purpose is not suitable, as all benign tumors on ultrasound look like hyperheogenic formation with reduced blood supply. Therefore, for differentiation, it is better to use computer or magnetic resonance tomography.

To benign kidney tumors includes the following types of education:

adenoma;
hemangioma;
oncocytoma;
angomiolipoma and others.

Kidney adenoma usually looks like a solid dense formation inside the kidneys. The cystic shape of the adenoma has the appearance of beesh cells. Adenoma almost with 100% probability is reborn into a malignant tumor, so it requires surgical removal. Lipoma is found in an octopic tissue as a rounded formation with a diameter of up to 3 cm. The lipom consists of adipose tissue and does not contain vessels.
Hemangioma is a congenital defect for the formation of kidney vessels, it is dangerous that in its break is formed internal bleeding. With the size of hemangioma, more than 4 cm is removed surgically.

Angomiolipoma for ultrasound kidneys

Angomiolipoma represents benign tumor kidneys consisting of fatty, muscle tissue and vessels in different ratios. This explains its complex name. This tumor grows slowly, several millimeters per year. With the size of angiolipomes, up to 4 cm only periodic monitoring of it is carried out. If it exceeds 4 cm in diameter, it must be removed surgicallySince the risk of tumor break appears. Angomiolipoma has characteristic signs of ultrasound, which allow it to unmistakably distinguish from other tumors.

Angomiolipoma is a rounded hyperechogenic education. The structure of this tumor on the ultrasound of a homogeneous, however, may include areas of necrosis in the center. On duplex ultrasound examination in the center of the tumor, the color signal is usually absent. With a radiological examination of the kidneys in the center of the tumor, a fatty tissue is revealed, which is characteristic of a given tumor.

Deciphering the result of the ultrasound of the kidneys. Conclusion ultrasound kidneys

After passing the ultrasound of the kidneys, the patient receives a blank with a conclusion about the study. It does not contain a diagnosis, but includes only the description of those structures that were discovered on the ultrasound. A photo ultrasound can be attached to the form ( the so-called Sonogram), which contains the most characteristic image obtained during the study.

It is necessary to understand that the conclusion of the ultrasound is intended for a urologist, who wrote down the direction for the study. Deciphering this conclusion spends urologist ( sign up) . He explains the patient the essence of the disease, prescribes treatment and controls the dynamics of the disease. That is, the patient does not have to understand the conclusion of the ultrasound, because it can get all the necessary information from doctors.

As already noted, the conclusion of the ultrasound contains a description of the structures, and not a diagnosis. Medicine is complex science, so changes can correspond to different diseases. Sometimes there are several diseases on ultrasound, in such cases, it is necessary to install the root cause. This is done precisely the attending physician, since he owns full information about the patient, ranging from the patient's lifestyle and ending with its blood and urine tests.

Form of imprisonment for ultrasound kidneys

Many curious to know what may include the conclusion about the passage of ultrasound and its result. The conclusion is written out on a document of a specific sample. It includes certain fields that fill the doctor or nurse during the study. As a rule, filling is carried out in parallel with the study, as it includes many quantitative and qualitative parameters.

The conclusion blank for the ultrasound of the kidneys includes the following sections:

Passport part. It contains a patient's name, age and diagnosis when appointing.
General information about the kidney. Describes the position, kidney mobility with breathing, its size ( length, width thickness).
Status of the kidney contour and capsules. The kidney circuit with diseases may be uneven or fuzzy, and the capsule is thickened.
Structure of parenchyma. Describes the cortical and brainstant. The doctor indicates data on the echogenicity of both substances, the nature of the border between them. In addition, the form and size of the pyramids are indicated.
Renal sinus. Refine the dimensions of the renal sinus.
Renal loch and cups. The diameter of pelvis and cups is indicated, since their expansion usually indicates diseases.
Pathological formations. If unusual education in the kidney is detected on the ultrasound, then their size, echogenicity, localization is described. These can be stones, cysts, tumors, or foreign bodies.

The form also indicates the party on which the kidney studied is also indicated ( right, left). When conducting a duplex ultrasound examination of the kidney with the CDC, an additional form is issued. It indicates the state of kidney vessels.

Blank ultrasound kidneys with color doppler mapping ( CDK) Contains the following information:

state of vascular pattern;
diameter, presence of essences or expansion of renal arteries;
diameter and features of renal veins;
the presence of additional vessels;
systolic and diastolic speed of blood flow of vessels inside the kidneys ( segmental, interdet, arc).

What does the increased and reduced kidney do ultrasound?

Some signs on the ultrasound kidneys can be interpreted in different ways. This also applies to the size of the kidneys on the ultrasound. Acute kidney diseases pass with an increase in the size of the kidneys due to inflammatory edema. In this case, there is a general decrease in the echogenicity of Parenhim. In chronic diseases, on the contrary, the kidneys decrease due to the thinning of the parenchyma.

However, the kidneys can be changed in size from birth. It is often underdeveloped ( gapopia) One of the kidneys. At the same time it is functionally defective. Because of this, the sizes of the second kidney increase to compensate for the function. This state usually does not require treatment. Therefore, in such cases, as the difference between the acquired and congenital change in the size of the kidneys, the decoding of the ultrasound is carried out by the attending physician with full information about the symptoms of the patient.

An uneven kidney contour on the ultrasound ( buggy kidney)

The bugger of the kidney contour on ultrasound is considered a sign of chronic pyelonephritis. However, only one of this feature it is impossible to make a complete picture of the disease. The fact is that the change in the contour can be observed as a residual phenomenon after sharp and chronic kidney disease. The functionality of the organ is of great importance. If they are normal, then the active disease is most likely absent.

The kidney circuit may vary if there are tumors or cysts. In this case, it acquires a rounded convex form. For tumors and cyst, there are own characteristic features. They are described in the form of inclusions in a kidney parenchyma with different echogenicity.

Signs of diffuse changes in the kidneys. A general reduction or increase in echogenicity of kidney parenchyma on ultrasound

One of the main characteristics of the conclusion on ultrasound is a description of the structure of parenchyma. The change in its echogenicity means certain deviations on the microscopic level. On the ultrasound it looks like a decrease or increase in the intensity of color pattern. In this case, the border and thickness of the cortical and brainstant in some cases may not change.

The echogenicity of the kidneys is reduced under the following diseases:

acute renal failure ( alcohol intoxication and other states);
acute pyelonephritis;
renal vein thrombosis;
underdevelopment ( gapopia) Kidney.

The renal echogenicity increases with the following states:

chronic pyelonephritis;
chronic glomerulonephritis;
diabetes;
gout;
amyloidosis.

How to notice, when acute diseases The renal echogenicity decreases. This is explained by the fact that in acute inflammation, the liquid comes out of the vessels and accumulates in the intercellular space. A large amount of fluid absorbs ultrasound waves, which is why the image becomes less contrasting. In chronic diseases in the kidney tissue in excess, a connecting fabric is formed, which is why it looks brighter than ordinary kidney.

Local limited kidney changes on ultrasound. Hyperehogenic inclusions, stains for ultrasound kidneys. Symptom of released pyramids

The most frequent find on the ultrasound of the kidneys are local pathological education. They can be the most various shapes, sizes and colors. Colour ( ehogenesis) These entities on the ultrasound speaks of their density. Based on this, you can make an assumption about their composition. Due to the large number of kidney diseases, in which spots or local entities are detected on ultrasound, in order to confidently understand them, a significant medical experience is required.

Various types of local changes on ultrasound

Ultrasonic characteristic

Color on ultrasound

Relevant pathological education

Anechogenic inclusions

Cysts, malignant tumors ( carcinoma), renal tuberculosis, expansion ( ectasia) Chescho-laughter system.

Hypoheochogenic inclusions

dark grey

For heart diseases ( for example, chronic heart failure) The heart throws blood with a smaller force. Because of this, the systolic rate of blood flow in the renal arteries falls. At the same time, the kidney function is reduced, therefore, the doctor makes conclusions about renal failure. To identify the root causes of these states, you need to hold ultrasound kidneys in conjunction with the ultrasound of the heart.

Heart ultrasound is called echocardiography. It can also be carried out using color doppler mapping. Heart ultrasound provides detailed information on valves and heart chambers. Hypertensive disease is an indication for the kidney and heart survey at the same time. Cardiologists take part in the treatment of this disease together with nephrologists.

Ultrasound kidneys, ureters and bladder

Most often, the ultrasound of the kidneys is carried out in conjunction with ugily bladder ultrasound. This is done in order to examine the whole urinary system. Urine changes can occur due to diseases of any organ constituting the urinary system. A stone formed in the kidney can shift to the entrance to bladder, Blocking urine outflows in this area. In all these cases, ultrasound is required not only kidneys, but also ureachers with a bladder.

The kidneys may be due to the disease of the bladder or ureterals. Very often, the infection rises from the bladder into the kidneys. So develops pyelonephritis. Tumors, chronic urinary bubble diseases ( cystitis) Enhance the risk of kidney damage and require treatment.

Ultrasound of the bladder is necessarily performed when filling it. Ureterals may not be visualized on the ultrasound, so their surveys are difficult. However, when there is a stone and expansion in them, due to the violation of the outflow of the urine, their walls are becoming visible on the ultrasound. In the injuries of the kidneys and bladder ultrasound, the ultrasound is carried out in the shortest possible time to determine the need for surgical intervention.

Ultrasound kidneys and abdominal organs ( pancreas, spleen, adrenal glands)

The ultrasound of the kidneys is very often combined with the ultrasound of the abdominal organs. This is done to establish a differential diagnosis or a comprehensive patient examination. Despite the fact that the kidneys are for the trousers, they are very conveniently examined together with the abdominal bodies due to topographic proximity.

Ultrasound examination is indispensable in the difference in renal and liver colic. Most often, the ultrasound of the kidneys and the liver is carried out together to detect stones, due to which a strong pain of the right appears, in upper departments Belly and lower back. Stones can be located in the kidneys and in the bustling bubble. Despite the fact that during a clinical examination, it is possible to find out the location of the stones, this examination is complemented to ultrasound for confident diagnosis.

In the presence of stones in the bustling bubble and strong non-terminating pain, an operation is carried out to remove them. At the same time, for the treatment of acute renal colic, successful use is possible conservative treatment. In order to disrupt stone from the kidneys, antispasmodics are used, local heat use.

Ultrasound kidneys and prostate ( prostati)

The difficulty of urination can be caused not only by kidney diseases, but also diseases of the prostate gland.

For a donow people, the words "hypochogenic education" sounds like a diagnosis, but it is not. Under this concept, various diagnoses can be hidden, from cyst to endometrial cancer.

What is meant by hypo echogenic education?

Everyone is familiar to the procedure, which consists in the direction of high-frequency sound waves on a certain organ. The sound is reflected from the tissues, and a picture appears on the monitor from a specialist. This procedure is called even echography, since the device works on the principle of echo.

Each body in the human body has its echogenicity and homogeneity (or heterogeneity) of the structure, an experienced doctor knows these differences and understands whether there is pathology.

A hypo echogenic education in the uterus ("Gipo" - lowered, lower) is a piece of tissue with less echogenicity than the remaining uterus fabrics.

In this place, the ultrasound is moving slower, the doctor sees it on the screen as blackout. Most often, vascular formations filled with liquids have such a structure, that is, such an education may be a cyst or tumor. However, the specialist will not write in the "cyst" form, since for a more accurate formulation of the diagnosis, a further examination is necessary, such as biopsy.

If the doctor noticed a dark education on the screen, which it determines as a hypooehogenic education, it must describe this section in detail: its size, contours. All this will help the gynecologist to determine the diagnosis and appoint. It is worth remembering that hypooechogenic education is not always a sentence and a terrible diagnosis. Ultrasound has its own errors and disadvantages.

Image quality depends on many factors that affect the result:

Experience specialist. The human factor plays a role, the doctor can also be mistaken.
Preparation for the survey. Before the procedure you will be prevented about how to prepare. Most likely, the nurse will ask to go to the toilet and empty the bladder, and also inquire the phase of the cycle.
Uzi apparatus. There are outdated devices, but this will meet infrequently. The higher the speed of the sound waves, the clearer picture.
Features of the patient. All should be taken into account: the presence, anatomical features, pathology, cycle phase, presence or absence, etc.

Possible causes of education

After an ultrasound specialist describe the formation, and the gynecologist will conduct all the necessary, treatment may be diagnosed: treatment:

Carcinoma of the uterus. Another name of this disease is the uterus body cancer or endometrial cancer. Usually a woman comes to a doctor with bleeding, which does not pass even after graduation, the doctor sends a patient on an ultrasound, where heterogeneous education with various cystic inclusions and other pathologies is found. The main method of treatment is surgical, if there are no contraindications to surgical intervention. The radiation therapy is also used. The forecast depends on which stage the disease was discovered.
Cervical carcinoma. it malignant tumor In the region of the cervix, which is closest to all the vagina. The cause of the development of cancer is a human virus, however, the presence of HPV in the body does not mean that the woman will definitely get cancer, there are other risk factors, such as random sex, frequent delivery, smoking, weak immunity. Quite often, such tumors are found in pregnant women, so each pregnant woman must pass a thorough examination in the early stages.
Cysts. Cearance called benign educationwhich does not lead to cancer and does not affect reproductive feature. Almost every woman faces this concept. Cysts can develop for a variety of reasons: hormonal disorders, injuries in abortion and childbirth, genital disease. Only large cysts are subject to removal. To do this, apply puncture, cavity, laser removal, radio wave.
Interior. The mucous membrane grows into muscle tissue, which causes pathology. This disease is more often found in women older than 35 years. It is accompanied by bloody discharges, pain in the abdomen and lower back, infertility. There are several stages of the disease, from one or more lesions of the defeat to the complete inconvenience of organs, rectum, vagina. Treatment can be both medicated and operational. With a small number of foci, the doctor prescribes hormonal pills, which also increase the chances of pregnancy.

Hypo echogenic education during pregnancy and after childbirth

Pregnant women are especially concerned with various pathologies found during. It is easy to explain the fact that the woman is worried not only for himself, but also for the child.

During pregnancy, hypo echogenic education in the uterine cavity can be discovered. It can be a functional cyst that will not harm, or a blood clot, which is a threat to. The source of the bunch can be small vessels damaged during the implantation of the fetal egg. If the hematoma is growing, it can provoke miscarriage, so regular ultrasound control is recommended. In the process of examination and observation, it will be visible how long the clot was formed, whether it was progressing, as far as it is dangerous in size and location for the fetus.

Only a gynecologist can appreciate the danger of the situation, what kind of cysts showed and what treatment will be the most productive.

In case of danger, a woman will be offered to go to the hospital, where the medical staff will constantly observe it and preserving therapy will be carried out. In some cases it is necessary to interrupt pregnancy.

More information about HPV and cervical cancer can be found from the video.

Hypoheochogenic education after childbirth (especially if the woman gave birth to recently) may be associated with an insufficient cutting of the uterus. In this case, the uterus has an enlarged size and empty empty. Often it is associated with inflammation. The doctor can advise breastfeeding, since in the lactation process is produced by oxytocin, causing contraction of the uterus. With strong inflammation, antibiotics and antibiotic can be assigned to avoid spasm of the cervix.

After abortion and childbirth, the gematometer of the uterus may occur, that is, the accumulation of blood in any portion of the uterus.

It can be accompanied by strong pain at the bottom of the abdomen and a sharp cessation of bleeding, standard after childbirth and abortion. It is allows you to identify this pathology. Treatment is to take reduction drugs that are removed from the uterus of the uterus. If the therapy does not help, the liquid is sucked by the probe. This procedure cannot be carried out with strong inflammation, so it is first recommended to put the course of anti-inflammatory drugs.

Features ultrasound uterus

As mentioned above, not always the result of ultrasound is reliable. Like any medical procedure, requires preparation and has its own characteristics. Even if the doctor has written in the conclusion of "hypochogenic education", the gynecologist will most likely advise you to make another person from another specialist on another apparatus to confirm the availability of this education.

Ultrasound can be different:

Without internal administration of the device (through belly)
With the introduction of the apparatus inside the vagina, through the rectum of virgins or in rare cases with the introduction of a thin probe directly to the uterine cavity.
Sometimes the doctor combines several methods.

The nurse will surely warn you about how to prepare for the survey so that the results are the most accurate:

When examining without internal administration, it is recommended to drink to fill the bladder, it will help a specialist to see the pathology.
With internal administration, on the contrary, it is necessary to empty the bladder and the intestine can be cleaned per day. All these procedures reduce the risk of errors during the survey.

With a transvaginal examination, a special nozzle (or a condom) is also used. This is the best way to estimate the state of the cervix. The accuracy of the result also depends on the cycle phase. The most accurate results are obtained at the beginning of the cycle when endometrium is thinned and does not interfere with consider all pathology, polyps and cysts.

If the ultrasound procedure is urgent, but the phase of the cycle is unsuitable, the patient may be asked to repeat the examination after the start of menstruation (for 5-7 days).

Do not be afraid of any irradiation. - Absolutely safe method, it can be carried out as often as necessary. This is an affordable procedure, which can be used in any medical center.

The result can be assigned by a doctor to confirm the diagnosis, in case of appearance anxiety symptoms (pain, bleeding, selection), as prevention or to verify efficiency. After childbirth, the woman is assigned an ultrasound to test the uterus cuts, the presence of bunches and the state of the seam after the cesarean section.

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When, after the ultrasound of the ultrasound, the woman comes out with the results of the study on the hands, like anyone who is not accustomed to himself a person, she will want to know whether her genitals rightly recognize. This requires decryption ultrasound uterus and appendages. And there is a medical education far from every woman and not everyone can competently discharge. Let's figure out with normal indicators of the ultrasound of the female genital organs.

Norm when ultrasound uterus

Finding the uterus

Let's start with the fact that each body must be in its place, or at least not to deviate from the "course". So with the uterus. Normally, the body of the uterus is located like this: it is tilted by the kepened, the fold between the body and the cervix forms a stupid angle. In conclusion on the ultrasound, it can be written as in Russian, that is, normal, or in Latin, for example Anteflexio or Anteversio. As an option, the norms consider and the bend of the body of the uterus towards the rectum, then, depending on the pathology under study, this species can be denoted as the norm, or as a deviation. In Latin, it will be read like RetroFlexio or Retroversio. Sometimes a similar arrangement of the uterus in a small pelvis may cause infertility or testify about diseases of the small pelvis organs. But the precise picture can tell you your attending physician, relying on the dynamics of life and the development of your body.

The size of the uterus

The ultrasound scanner allows you to remove three measurements from the uterus - transverse, longitudinal and front-rear. The front-rear size of the uterus, it is called the thickness, in the normal state is 40-45 mm. Transverse size, That is, the width will be 45-50 mm for bombing women and up to 60 mm in those who already have children. The longitudinal size, also referred to as a length of the uterus, in the giving birth can reach up to 70 mm, and at the annoying - 45-50 mm. Of course, there are averaged figures. Each woman has an individual with an individual, there may be minor deviations that will approach your personal norm. In any case, if ultrasound uterus does not your attending physician, then indicators that differ from the ideal ideal in normal anatomy will be recorded as deviations. Again, too large uterus sizes can occur in women with various pathologies, then additional research will be needed.

Endometry thickness

This indicator on ultrasound is removed by determining the echogenicity of the endometrium, that is, the inner layer of the uterus. It is important to take into account the day of the menstrual cycle when the study is carried out. During cyclic changes from the beginning of the cycle and to its end, this layer is growing day after day and this is normal. For example, for the first half of the menstrual cycle, the values \u200b\u200bof its thickness from 3 to 10 mm will be fair. After ovulation, that is, in the second half of the menstrual cycle, these indicators will be considered normal at values \u200b\u200bfrom 18 to 21 mm, especially in days before the start of monthly bleeding. For mature womenespecially for those who have already occurred menopause this value will be 5 mm, of course, in normal condition female health. With the elevated thickness of this layer, additional research is needed to exclude different pathologies.

Miometrium research

The thick uterine layer is its muscular component - myometriy. On ultrasound, the uterus usually explore its structure. During the normal state of the uterus, this layer will be homogeneous. With other indicators, it will be advisable to undergo additional research.

Norma with ovarian ultrasound

The position of the ovarian

The ovaries are an even more interesting structure than the uterus. They are all the life of a woman, and especially in the years of its sexual activity and maturity undergo changing. The only relatively permanent state should be their position. Normally, the ovaries are on the side walls of a small pelvis, just at the site of dividing the iliac artery. Regarding the uterus, they must be on the side of her or a little shifted by the stop. But, again, for each of their norms, therefore it is not necessary to get upset hard if something "grows" is not on the textbook of anatomy. All questions will be able to clarify your gynecologist.

Sizes of ovarian

It is advisable to shoot the normal figure at the beginning of the cycle to ovulation, when the follicle (capsule with a ripened egg) has not yet grown, as well as a yellow body (a temporary phenomenon designed to maintain pregnancy with the help of a hormone-supporting hormone). With the help of ovarian ultrasound, the measurements of thickness, lengths, widths and volume are removed. The following parameters are characteristic of the "mature" ovary: the volume from 40 to 100 mm3, the width of 18 to 30 mm, length from 20 to 37 mm and a thickness of 16 to 22 mm. For women who survived menopause, these indicators will be different. The volume will be from 15 to 45 mm3, width - from 12 to 15 mm, length from 20 to 25 mm, thickness from 9 to 12 mm.

The structure of the ovarian

This indicator is the most interesting field for research. Not only the ultrasound of the ovaries can be viewed, but also with the help of this survey, it is possible to determine many factors. In the first phase of the cycle, they are viewed, first of all, against the background of the entire structure of follicles, ready for ripening. Of course, only one of them becomes a leading and can be up to 18 mm closer to ovulation. When ovulation itself is performed, the so-called yellow body is formed on the site of a broken follicle - a temporary body that produces hormones that allow the endometry to grow. In addition to the inner layer of the uterus, it affects other structures of the body. In the active phase, the yellow body "lives" about 9 days, and, if no fertilization occurs, it gradually decreases in size. It is these structures that should be noticeable to the ovarian ultrasound. All other things that can be discovered - will be considered pathology. If we take the echogenicity of this body for the indicator, then against the background of a yellow body or follicles, the ovary will "look" homogeneous.

This is the ultrasound ultrasound data and appendages are considered normal. Other metric and not metric values \u200b\u200bare considered, if not pathological, deviations from the norm - for sure. But, if in his conclusion you wrapped the mark that you have a suspicion of the disease - do not rush to beat the alarm. Just show your doctor the results, as well as come for a full-time survey on the chair. The fact is that it is the doctor who will be able to determine what the norm is for you, and what already requires treatment.

Ultrasound, today, is hardly the main method for confirmation and diagnosis in the problems of female sexual sphere. As a result of the examination, the doctor receives a visual picture of the small pelvis organs, it has the ability to assess their structure, shape, size, presence or absence of foreign inclusions. As a rule, a description of the organs obtained from the doctor's doctor, more or less understandable even inexperienced in the issues of gynecology to patients. What is ovarian or uterus, know almost everything, but a rare patient familiar with the term M-echo. What is M-ECHO, in relation to female childbearing authorities, and what are its standards?

Definition

M-Echo - What is this term? This is a specialized term, which is used in the description of the results and denotes the parameters of the thickness and structure of its inner cape (endometrial).

The stable signal with the maximum amplitude shows the so-called median structure of the uterus, that is, its inner mucous dilution. Therefore, the second name M-ECHO is a median echo. The state of the endometrial layer depends on the menstruation phase. The increase in the layer is directly dependent on the level of female genital hormones, which changes during the transition from one phase of the cycle to another.

Endometrium is a mucous inner layer of the uterus, lining and protecting her fabrics. It is his characteristics that call M-Echo

Communication of endometrial structure with a cycle phase

Standards developed for ultrasound diagnostics are based on averaged cycle duration of 28 days. If the patient has a cycle of different, when conducting a study, amendment is made to the duration of menstruation. The first day of menstruation is determined by the beginning I phase of the cycle. In the first half of it, the thickness of the endometrial system increases under the influence of estrogen (proliferative / follicular phase).

In the second half (after the ripening of egg-ovulation) the structure of the endometrium changes, it becomes spongy and thick, prepares for the possible introduction of a fertilized egg in its thickness. There is a process under the influence of progesterone (lutein / secretory phase). If the fertilization process did not take place, then the production of hormones (estrogen and progesterone) decreases, the endometrial layer is rejected (period of desquamation / menstrual bleeding).

Why study the state of the endometrium?

The ability of a woman to childbear largely depends on the state of the endometrial layer. During ultrasound examination, not only the structure of the inner mucosa of the cape and its thickness is determined, but also the correspondence of the parameters of the phase of the menstrual cycle.

The purpose of the study is to identify possible deviations in its functional state and the ability to implantation of zigotes. With the ultrasound of the female genital organs, the assessment of the state of the endometrial layer is always carried out and does not depend on the age of the patient.

Visualization of healthy endometrial

phase desquamation;
proliferation;
preventive;
lutein phase.

Each of the phases of the cycle has its own visual picture, reflecting the state of the mucous membrane of the uterus and differing from other phases. AT I phase (desquamations) In the uterine cavity Uz-diagnostics shows small inclusions, inhomogeneous by structure (visualization of blood clots), having a different echogenic structure (hypo-, and hyper-). In normal condition, the uterus cavity can be slightly expanded (up to 5 mm). The duration of this phase is 3-7 days.

Next to the queue is a proliferative II phaseShe lasts up to 14 days. During this period, the endometric layer increases with a speed of 0.1 mm per day. In this phase, the mucous dilution of hypooehogenne has a uniform structure. The border with the myometrium is clearly pronounced. The walls of the uterus (front and rear) have a smooth hyperheogenic connection line. Such a visual picture of the M-echo is called the 3-layer.

In different phases of the female cycle, the M-ECHO picture on the ultrasound will look different. This is due to the level of hormone content.

The proliferative phase ends with ovulation. It lasts a very limited period of time (from minutes to hours), "catch" this moment is almost impossible for the ultrasound. Usually the diagnostic is already observed by the consequence of ovulation. The proliferative phase smoothly goes into lutein. Often the moment of transition is highlighted in self III phase - Precision.

During the prevention period, M-echo has a five-layer structure, reaching in the amount of 10-12 mm. During this phase, the echogenicity of the endometrial layer is observed, which is practically compared with the echo of the muscle layer. Well visualizes a thin strip in the center. Endometrium on the echo structure is homogeneous.

Then the echogenicity of the endometrium increases, exceeding the echogenicity of myometrium. Coming IV Secretor Phase. In some cases, increased grades of glands are visualized as small anechogenic structures. The thickness of the M-Echo grows, albeit a slower pace, reaching 15 mm. Norma is its maximum size.

Standards

The norms of the thickness of the M-echo of the uterus of women of childbearing age change for every few days of the cycle. Below is a table with normal ultrasound-research rates for healthy women (with deformed myomatous nodes by the ultimate ultrasound) at a degenerate age, the menstrual cycle of which is 28 days.

If the menstrual cycle in women lasts longer than 28 days, there is a lag in the growth of endometrial. If the cycle is 21-27 days (i.e. less than 28 days), there is an acceleration of the rise of its thickness.

With M-ECHO, about 2 mm, it is necessary to undergo a survey of the hormonal background with the study of the function of the ovaries and the thyroid gland. The middle layer of the uterus 2 mm is too thin mucosa layer. Normally, such an indicator can not be. The thickness of the layer in 6 mm is considered the norm for the end of the cycle, at 13 mm - for 15-21 days.

Visualization of the uterus in women of childbearing age and patients in menopause has significant differences. In the post-block cell period, female sex hormones are produced with significantly lower intensity. Echogenicity of the mucous membrane of the uterus in patients in menopause high, contours are clear. M-ECHO thickness depends on the time limit of Klimaks:

up to 5 years ago - M-echo no more than 5 mm;
after 5 years - thickness within 4 mm;
if the climax has long ago, the endometrial layer may not be determined under UP-study.

The ultrasound ultrasound indicators are analyzed with age features Patients, menstrual phases and therapy with hormonal drugs (if it is carried out), as well as a number of other factors that the doctor establishes by collecting anamnesis (survey) of the patient. Having on the hands only digital M-echo data of endometrial thickness, it is impossible to judge the presence or absence of pathology. The results should evaluate a specialist.

Uterus

The regulations of the sizes of the neck and body of the uterus in women of reproductive age, taking into account the obstetric and gynecological anamnesis in table 1. . It should be noted that not only preceding pregnancies affect the uterus, but also the phase of the menstrual cycle - the uterus is relatively reduced into the proliferative phase and relatively increased at the end of the secretory phase. The size of the uterus can change slightly depending on the research technique. When the thickness of the body can be somewhat reduced due to the compression by the overcrowded bladder, and on the contrary, when you are somewhat increased by increasing the tone of myometrium.

Table 1. The dimensions of the uterus in reproductive age (M ± SD)

Group	Cervical Length (cm)	Cervical thickness (cm)	Width of the neck (cm)	Body Length (cm)	Body thickness of the uterus (cm)	Body width of the uterus (cm)
There were no pregnancies	2.9 ± 0.5.	2.6 ± 0.4.	2.9 ± 0.5.	4.4 ± 0.6.	3.2 ± 0.5.	4.3 ± 0.6.
Only abortion	3.1 ± 0.5.	2.7 ± 0.4.	3.1 ± 0.5.	4.9 ± 0.6.	3.7 ± 0.5.	4.6 ± 0.5.
Childbirth 1.	3.4 ± 0.6.	2.8 ± 0.4.	3.3 ± 0.5.	5.1 ± 0.6.	3.9 ± 0.5.	5,0 ± 0.5.
Birth\u003e 1.	3.7 ± 0.6.	3,0 ± 0.5.	3.4 ± 0.5.	5.6 ± 0.9.	4.3 ± 0.6.	5.5 ± 0.5.

The form of the uterus is pear, and after multiple pregnancies tends to roundness. The miometry is normal to have an average echogenicity comparable to the echogenicity of the parenchyma of the unchanged liver, the pancreas as well as the cortical layer of the kidneys.

Endometry's ultrasound anatomy is advisable to be considered in relation to various phases of the menstrual cycle (it will be about the so-called "ideal" cycle, laid 28 days, with ovulation on the 14th day).

In the early proliferation phase (5-7 days of the cycle), the endometrium has relatively low echogenicity and a homogeneous ehostructure. The thickness ranges in the range of 3-6 mm, constituting on average 5 mm. In the center of the M-echo, a hyperheogenic thin line can be determined during this period, representing the boundary of the contact of the front and rear leaves of the endometrium (Fig. 1).

On 8-10 days of the cycle (average proliferation), the endometrium is somewhat thicken - an average of up to 8 mm (fluctuations of 5-10 mm). The echostructure compared with the previous period practically does not change (Fig. 2).

The late proliferation phase (11-14 days), in addition to further thickening, on average up to 11 mm (oscillations of 7-14 mm), begins to slightly increase the echogenicity of the endometrium - at this stage it can be called medium (Fig. 3).

For the early secretion phase (15-18 days), a slower growth rate of endometrial is characterized, but the latter still continues to thicken, reaching an average of 12 mm (fluctuations 10-16 mm). Echogenicity continues to rise, and this comes from the periphery to the center, as a result of the hypooehogenic central fragment of the endometrium takes a drop-shaped species (a wide part in the bottom of the uterine bottom, narrowing towards the neck). In this phase, the hypeochogen line in the center is already visualized by fuzzy (Fig. 4).

For 24-27 days of the cycle (late secretion), the endometrium thickness slightly decreases - on average 12 mm (fluctuations 10-17 mm). An essential feature of this period is the high echogenicity of the endometrium in combination with a non-uniform inner echo-eulation, due to which the line of closure of the sheets ceases to be visualized (Fig. 6).

When dopplerography, the uterus draws attention to changes in the indicators of both speed and blood flow resistance, and depending not only on the vessel caliber, but also on the menstrual cycle phase (Table 2).

table 2.
Dopplerometric indicators of normal uterine blood flow
[Own data].

Day cycle	Maximum arterial speed (MAS) cm / s				Resistance Index (IR)
Day cycle	Uterine artery	Archite artery	Radial artery	Spiral artery	Uterine artery	Archite artery	Radial artery	Spiral artery
5–7	42.4 ± 0.4	30.2 ± 0.4	10.2 ± 0.2	7.5 ± 0.2.	0.88 ± 0.2.	0.82 ± 0.1	0.76 ± 0.3	0.55 ± 0.4
8-10	43.7 ± 0.6	32.1 ± 0.5	10.8 ± 0.3	7.7 ± 0.2	0.89 ± 0.2	0.80 ± 0.1	0.72 ± 0.2.	0.53 ± 0.2.
11-14	48.3 ± 0.7	37.3 ± 0.3.	12.2 ± 0.4.	8.1 ± 0.4	0.87 ± 0.2.	0.77 ± 0.2	0.66 ± 0.2.	0.51 ± 0.3
15-18	49.4 ± 0.6	38.1 ± 0.2.	14.1 ± 0.7	8.7 ± 0.3	0.85 ± 0.1	0.74 ± 0.2	0.66 ± 0.1	0.50 ± 0.4
19-23	51.2 ± 0.5	40.4 ± 0.4.	16.5 ± 0.7	9.2 ± 0.6	0.83 ± 0.2.	0.72 ± 0.2.	0.68 ± 0.2	0.48 ± 0.3.
24-27	50.1 ± 0.2	42.3 ± 0.3.	16.6 ± 0.4.	9.1 ± 0.3.	0.85 ± 0.2.	0.74 ± 0.3.	0.70 ± 0.3.	0.52 ± 0.4.

Dopplerographic Evaluation of the endometrium is of particular importance in the search for gynecological pathology and should be carried out in the early proliferative phase. It is important to emphasize the absence of visualization of intnendometric blood flow during this period.

In postmenopausal, the uterus gradually decreases in size (Table 3).

Table 3.. Postmenopausage uterine sizes (M ± SD)

The uterine cavity in postmenopause is an M-echo in the form of a thin hyperheogenic line with a thickness of 1-2 mm (Fig. 8). The permissible top boundary of the postmenopausage norm should be considered a M-echo thickness of no more than 4-5 mm (in more detail in the section "Endometrial pathology"). With a postmanographic examination in postmenopausal, intra-endometric blood flow is not visualized.

Ovarian

The ovaries are usually located on the side walls of the pelvis in the so-called ovarian holes - the deepening of the parietal peritoneum at the division of the general ileum artery to the outer and internal. Echographically, they can be visualized mainly on the side of the uterus, but often they are determined by the stop from it or adjoin one of the uterine corners. As already mentioned, with difficulties in the search for ovary, the internal iliac artery and Vienna can serve as anatomical benchmarks. Normally, the ovaries are well moving and easily displaced when pressing a transvaginal sensor. Ovarian shape Ovoid and fightened front back. In the reproductive age, the echographic sizes of the ovaries fluctuate in large limits (Table 4), and this is a large extent depends on a number of factors: age, reproductive history, the phase of the menstrual cycle, the reception of oral contraceptives, etc.

Table 4.. Dimensions of ovarian in reproductive age. [Own data]

The dimensions of the right and left ovaries in the early proliferation phase are almost the same, but then they can differ significantly depending on the number and size of anthral and dominant follicles, as well as a yellow body. Thus, to identify a pathological increase in ovaries, the study should be carried out on 5-7 days of the menstrual cycle, while the decisive should be considered the definition of not linear dimensions, and the volume, which is normal in the norm exceeds 10 cm3.

On most of the surface, the ovary does not have a serous shell and is covered with only one layer of mesothelial cells that form a surface (germ) epithelium. The function of the missing capsule is performed by fibrosted surface layers of the cortical layer. The echographs described above the anatomical structures are not visualized. The place of entry of the main vessels is called the ovarian gates, confidently defined during ultrasound examination only with the help of color dopplerography.

The inner anatomy of the ovary, as well as the uterus, it is advisable to consider in relation to various phases of the menstrual cycle. The ovarian stroma representing the connecting and intestinal basis of the cortical substance, echographically visualized as a zone of medium echogenicity, mainly located in the central part of the organ (Fig. 9).

The ovarian cortical substance contains follicles of varying degrees of maturity (follicular apparatus). Numerous (hundreds of thousands) Primordial, primary, and secondary follicles are not determined at echographs, since their dimensions do not exceed 400 μm.

In the early proliferation phase or early follicular phase (5-7 days cycles), the visualized part of the follicular apparatus is mainly 5-10 tertiary, or antral follicles. The latter have the form of rounded echonegative inclusions with a diameter of 2-6 mm, located mainly along the periphery of the ovary (Fig. 9). The network of spiral vessels around the developing follicle occurs already at the beginning of the antral phase. At the same time, blood flow is visualized in the form of a few color loci in stroma and the periphery of antral follicles (Fig. 10).

On 8-10 days of the cycle (average proliferation or average follicular phase), a dominant follicle appears (Fig. 11), the diameter of which is already 12-15 mm and continues to increase, while the growth of other follicles stops, and they reaching 8- 10 mm in diameter, subjected to atresia (which is echographically determined in a gradual decrease and disappearance by the end of the menstrual cycle). The blood supply to the dominant follicle usually occurs due to two or three stromal arteries, as a rule, visualized along the periphery, or even in the latter wall (Fig. 12). At the same time, the dopplerometric indicators of the stromal arteries and the arteries of the dominant follicle are not significantly different.

In the lateral proliferation phase or late follicular phase (11-14 days), the dominant follicle increases by 2-3 mm per day, reaching 18-25 mm ovulation (on average 20 mm). To the prognostic signs of ovulation, indicating that the latter will occur in the next few hours include: the diameter of the dominant follicle of 18 mm, the double circuit around the latter, as well as fragmentary thickening and irregularity of the inner contour of the dominant follicle. Vascularization of the dominant follicle becomes subjective more noticeable compared to other follicular structures, too, only on the eve of ovulation (Fig. 13).

Qualitative changes in the blood supply to the dominant follicle during this period are characterized by a decrease in resistance compared with other intraval arteries. A. Kurjak and S. Kupesic believe that the prognostic doppler signs of ovulation should be considered the merger of color locations along the periphery of the follicle to the appearance of the "ring" and the decrease in the resistance index to 0.5 and less. On the ovulation occurred, it is necessary to judge the disappearance of the dominant follicle or a decrease in its size with the deformation of the walls and the appearance of echogenic content in the cavity, as well as the appearance of a liquid in the douglas space.

For the early secretion phase or early lutein phase (15-18 days), the appearance of a yellow body with a diameter of 15-20 mm at a yellow body ovulation site (usually less than the dominant follicle) having an irregular shape, uneven contours, and an extremely diverse inner echostructure of varying degrees of echogenicity (rice . 14). This peculiar echographic polymorphism is easily explained by the morphological substrate of a yellow body core, which is a blood clots in varying degrees of thrombosis and lysis.

The phase of the middle secretion or the middle lutein phase (19-23 days) for the "blooming" yellow body is characterized by some increase in diameter (up to 25-27 mm), as well as the appearance of an uneven thickened echoposive roller. The echoity of the content due to lysis can gradually decrease down the formation of a "cystic" yellow body (Fig. 15-16).

During the first days after ovulation around the yellow body, a dense, multilayer vascular network is formed, especially expressed in the heyday phase. On the color dopplerograms around the yellow body, a pronounced color ring appears (Fig. 17-19), the blood flow in which is characterized by high speed values \u200b\u200band low impedance (Fig. 20). This is typically for turbulent physiological neovascularization.

For 24-27 days of the cycle (late secretion or late lutein phase), the "fancy" yellow body decreases in size (10-15 mm), its echogenicity increases somewhat, and the echostructure becomes more uniform. At the same time, the yellow body echographically often begins poorly visualized (Fig. 21). In the absence of pregnancy, the blood supply to the yellow body begins to change approximately 9 days after ovulation. The yellow body fabric begins to undergo luteolesis, capillaries are reduced and reduced, which is characterized by a noticeable depletion of local blood flow (Fig. 22).

During menstruation, the yellow body is already not determined, or in its place there is a fuzzy echostructure of increased echogenicity with a diameter of 2-5 mm (white body), which usually disappears without a trace during the next menstrual cycle. It has been proven that the non-passable white body in the form of a scar is preserved only after a gravidar yellow body. Blood circulation in the vessels of the fading yellow body is terminated, and the vessels themselves disappear throughout the first three days of menstruation.

The results of studies of dopplerometric indicators of intricarial blood flow conducted by many authors as well as our own data (Table 5, Fig. 23-24) demonstrate substantial cyclic changes in the speed and peripheral resistance of the intoryal blood flow in the ovarian ovary in various phases of the menstrual cycle.

Table 5. Dopplerometric Indicators of Normal Intoryal Bloodstock

Cycle Day	Maximum arterial speed (MAS)		Minimum resistance index (mini)
Cycle Day	Ovulating ovary	Non-ruining ovary	Ovulating ovary	Non-ruining ovary
5-7	13.6 ± 0.8. (9,8-19,8)	8.7 ± 0.8. (4,7-14,3)	0.49 ± 0.01. (0,45-0,55)	0.54 ± 0,01 (0,48-0,61)
8-10	16.6 ± 0.7 (13,4-19,5)	10.6 ± 1.0 (8,0-18,4)	0.51 ± 0.02. (0,38-,60)	0.52 ± 0.02. (0,40-0,62
11-14	18.6 ± 0.5 (16,3-20,9)	9.6 ± 0.5 (8,6-10,6)	0.49 ± 0.02. (0,45-0,52)	0.51 ± 0.020 (0,42-0,57)
15-18	23.2 ± 0.7 (16,8-26,1)	8.9 ± 0.6 (6,6-14,5)	0.43 ± 0.02. (0,41-0,49)	0.51 ± 0.03. (0,46-0,62)
19-23	29.8 ± 2.1 (21,6-46,5)
Ir Ir Ir Franval Bleeding during a 28-day menstrual cycle with ovulation on the 14th day

So the indicators of Mas, increasingly increasing over the entire proliferative and early secretory phases, increased jumpingly during the heyday of the yellow body, reducing again during the period of fading the latter. In turn, the mining indicators in the ovulant ovarian were also almost not changed during the entire proliferative phase, dramatically decreased after ovulation and reaching a minimum to the flourishing of the yellow body, and then rising again by the end of the menstrual cycle. It is important to note that the echostructure, as well as high-quality and quantitative indicators of the vascularization of the unwilling ovary practically do not change during the entire menstrual cycle.

In postmenopause, the ovaries significantly decrease (Table 6), while the size of the right and left ovary should be almost the same.

Table 6. The size of the ovaries in postmenopausal (M ± SD) [own data].

It should be emphasized that the indicators exceeding the boundaries of the age norm, as well as the difference in the volume of right and left ovaries more than 1.5 cm3 are signs of pathology. Asymmetric increase in one of the ovaries than twice should be considered a marker of malignization.

During the postmenopausal period, the follicular apparatus is gradually exposed to almost full reduction. The first 5 years after menopause in the ovarian parenchyma "have the right" to visualize single follicles with a diameter

Already a few decades It has passed how the ultrasonic diagnostic method is firmly entered into modern medicine. Its advantages are the relative ease of implementation, the absence of harmful effect on the body of the study, high informativeness. There are several types of ultrasound diagnostics, but the most common is the so-called in-mode - when the two-dimensional image is based on information from reflected waves. This method of medical imaging has long been the main method of studying many organs and systems, in particular, modern gynecology is impossible to imagine without an ultrasound. A study of a small pelvic of women is carried out almost exclusively by this method, only in some controversial cases resort to additional diagnostic methods.

To organs small pelvis in a woman Take almost the entire reproductive system - the uterus, uterine pipes and ovaries. Also in a small pelvis there are such organs as a bladder and a straight intestine, which can also be investigated using ultrasound. Nevertheless, the overwhelming number of ultrasound of a small pelvis in women is carried out precisely for the purpose of examining the eleven bodies.

For this purpose developed And two main intake of ultrasonic diagnostics, differing sensor position, is widely used. In one case, the sensor of the device is on the front abdominal wall, through which the organs are conducted. The advantage of this admission is the greater comfort of a woman under the procedure and the possibility of a certain maneuver at a researcher's doctor - if necessary, you can simply examine the urinary system, as well as nearby organs. However, it turns out a less clear image of organs - nevertheless there can be a significant fabric layer between the front abdominal wall and the uterus. Another reception is to introduce a sensor into the vagina (intravaginal ultrasound of the small pelvis organs) - this ensures the highest clarity of the image, since the source of ultrasonic waves is almost directly adjacent to the agencies under study. However, such a study requires a certain skill with a doctor and creates some discomfort for a woman, in addition, with such a method, it is impossible to continue to study the neargeneral tissue to the childbearing organs.

Depending on the reception Uzi small pelvis organs Women requires various preparations for research. Before the traditional study through the abdominal wall in about an hour, it is necessary to drink near the liter of water and not to go to the toilet until the end of the procedure is a filled bladder serves as a kind of "backlight" for the organs of the reproductive system. If it is supposed to use intravaginal ultrasound, then immediately before the study of the bladder needs to be emptied, that is, go to the toilet.

Within the framework of standard Uzi small pelvis organs in women The following characteristics are investigated:
- the position of the uterus in a small pelvis and relative to other organs;
- dimensions and contours of the uterus;
- the structure of various layers of uterus - mainly muscle (mineometry) and mucosa (endometrial) of the layers;
- characteristics of the uterine cavity (size, smooth walls);
- sizes and structure of the cervix;
- the size of the ovaries and their structure;
- the structure of the uterine pipes (if defined);
- The condition of the tissues surrounding the organs of the reproductive system.

A number of characteristics reproductive system organs In women of childbearing age, significantly change depending on the stage of the menstrual cycle, which should take into account the doctor. In addition, the ultrasound of the small pelvis organs can be prescribed to a certain day of the cycle for a more detailed study of a particular function of the reproductive system. Thus, the general study of the bodies of the small pelvis is best to hold on 5-6 days of the cycle, the beginning of which is reported from the first day of menstruation. For a more accurate examination of the endometrial structure, the second half of the cycle is suitable - after the 14th day, since during this period the uterus mucosa reaches the greatest thickness and the changes become more noticeable. To verify the formation of new eggs and the work of the ovaries, repeated ultrasound is often appointed - by 7, 14 and 22 cycles. This technique allows you to adequately evaluate the operation of the reproductive system in the dynamics.

Consideration of basic characteristics The small pelvis organs in women within the framework occur quite quickly, however, it is often not possible to give an accurate diagnosis and requires additional diagnostic methods. However, the high informativeness of the method helps to send a study in the right direction.

Position of the uterus - Normal is the location of the uterus in a small basin, when it is somewhat rejected forward from the vertical line of the body. In conclusion, the ultrasound is called AnteFlexio. Congenital pathology is considered to be the deviation of the uterus back - this may be the cause of infertility in a woman, and also significantly complicates the flow of labor.

Dimensions and contours of the uterus - The size of the uterus is strongly dependent on the number of women's birth and pregnancy, so the latter must necessarily inform the doctor about all pregnancies, including those who were interrupted at an early stage (miscarrout or abortion). With ultrasound, the abodes of the small pelvis in women are measured length, thickness and width of the uterus. In no pregnancies of women, the sizes of the uterus are respectively 44 mm * 32 mm * 44 mm. If there is a history of pregnancies without subsequent genera, the size of the uterus is somewhat increased - 49 mm * 37 mm * 46 mm, if the woman has already gone, then the normal sizes of the uterus will be 51 mm * 39 mm * 50 mm. After several genera, the size of the uterus can increase by another 4-5 mm, in any situation, oscillations from the specified values \u200b\u200bof 5-6 mm are considered to be an option for the norm. If, with ultrasound of the small pelvis, it is detected significantly reduced in the sizes of the uterus, this indicates its underdevelopment, an increase in the uterine can be caused by pregnancy or a tumor, the presence of the uterine contours is also indicated - in the norm of the outline of this body on the ultrasound of the rosary and even.
Structure miometrium Against the background of complete health should be homogeneous. The presence of inclusions with elevated echogenicity is regarded as a sign of the mioma of the uterus or other type of tumor.

Endometrial structure. The study of the uterus mucous membrane with ultrasound of a small pelvic organs is the greatest complexity, since the thickness and other characteristics of this layer are most varying through the menstrual cycle.
- In the first phase of the menstrual cycle - the phase of regeneration, 3-5 days - endometrium on ultrasound is defined quite badly, its thickness is 3-4 mm.
- Phase of early proliferation (5-7 days) - endometrium is thickened to 4-6 mm, but its echogenicity remains low, the structure of this layer is homogeneous.
- Phase of the middle proliferation (7-10 day) - the only difference in the ultrasound paintings from the previous stage is the thickening of the endometrium to 8-9 mm.
- The phase of late proliferation (10-14 day) is characterized by increasing thickness (up to 9-14 mm) and echogenicity of endometrial.

The phase of early secretion (15-18 day) - the thickening of the mucous membrane of the uterus continues, albeit a slower pace, the thickness of the latter by the end of the phase reaches 11-16 mm. Echogeneity of the endometrium begins to increase unevenly, ranging from myometrium to the uterine cavity, resulting in an area with reduced echogenicity in the center of the uterus.
- The phase of the middle secretion (18-23 days) - the thickness of the endometrium becomes the maximum for the entire cycle (12-18 mm), echogenicity also continues to increase, the hypo echogenic area in the center of the uterus becomes invisible.
- late secretion phase (23-27 days) - endometrial thickness decreases to 11-16 mm, its structure becomes inhomogeneous, lesions with increased echogenicity. The absence of such changes at this stage of the menstrual cycle indicates the decidualization of the endometrium - its preparation for the implantation of the embryo after successful conception.

The study endometrial In the dynamics or at least a description of its characteristics at a precisely defined day of the cycle (if a woman conducts a calendar) allows not only to determine the presence of pathologies in this layer, but to characterize the entire menstrual cycle, changes to which can be caused by various endocrine disorders.

The cavity of the uterus - As already mentioned, the size of the uterine cavity can vary greatly depending on the stage of the menstrual cycle and the thickness of the endometrium. However, in any case, the internal surface of the uterus should be clear and smooth, and in its cavity there should be no different echogenic formations - the non-accuracy of the contours indicates an inflammatory process (endometritis), and hyperachene formations are polyps or uterine tumors.

Cervix - Its sizes are also largely dependent on pregnancies and childbirth. Length, thickness and width of the neck are an important diagnostic criterion of cervical cancer. A woman who has not transferred pregnancy, the size of the neck is 29 mm * 26 mm * 29 mm. If there was an interrupted pregnancy, then the sizes of the cervix increase by 1-2 mm, after delivery, they make up 34 mm * 29 mm * 33 mm. The cervical channel must have a thickness of 2-3 mm to be hypo echogenic, as mucus is filled. The channel expansion or the change in the structure of the cervix, discovered when the ultrasound of the small pelvic organs, are a reason for inspection from the gynecologist and take the analysis to the analysis, since the cause of changes may be in inflammation or cervical tumor.

Ovarian Also undergo significant changes during the menstrual cycle and have a rather complicated structure. Normal dimensions ovaries on 3-5 days cycle are 30 mm * 19 mm * 27 mm, but the oscillations of the norm different women May be up to 10 mm. The surface of the ovarian is clear, buggy, in the inner structure, the medium echogenic brainstant is determined, consisting of fibrous tissue and a corticular layer containing the air-generated inclusions - follicles with liquid. At the early stage of the menstrual cycle, the size of the right and left ovaries is generally the same, subsequently one becomes more than the other at the expense of the developing follicle. For 3-5 days in the cortical substance of both ovaries contained 10-12 aerogenic formations in size 3-4 mm. On 7-9 days of the menstrual cycle, it is possible to determine the developing follicle, the diameter of which becomes 10-11 mm, while the dimensions of other follicles gradually decreases and they begin to disappear. In the future, the size of the follicle increases by 2-3 mm per day until ovulation (14-15 days), when its diameter is 20-25 mm. In the second half of the menstrual cycle, after ovulation, an area with uneven echogeneity is formed on the site of the follicula, a yellow body, a diameter of 15-18 mm. For 19-23 days of the menstrual cycle, the yellow grows, increasing to 23-27 mm, its echogenicity decreases. For 24-27 days, the yellow body begins to decrease dramatically, practically not aligned with menstruation. Its preservation and even some increase after 23 days of the cycle indicates conception.

The fallopian tubes In most cases, the ultrasound of the small pelvis organs are not determined. Their appearance in the study can speak of their inflammation, the uneven hyperhogogenic area at the satellite pipe indicates an ectopic (tubular) pregnancy.

Norma behind matties A small amount of fluid is determined, which is contained by the projection space of the abdominal cavity (douglas space). An increase in the amount of liquid behind the uterus or its appearance on the sides or in front of the body indicates inflammation of the tissue-surrounding uterus (parameter).

Echogenicity of Parenhima is an indicator of the valuation of the inspected body. This term is applied solely to describe the state of the organs under ultrasound examination.

Echogenicity is manifested by the ability of the body of the internal organ to reflect the ultrasound aimed at it. After that, the signal is fixed by the sensor from which the waves proceed and the image of gray shades appears on the screen.

Each organ has different echogenicity, which is homogeneous or inhomogeneous. The most dense organs on the monitor screen are reflected in a light gray tint, it means its echogenicity.

The organs with the liquid structure of the ultrasound wave do not reflect, and pass through themselves, which means echonegability. The norm is considered for the heart, stomach, intestines, urinary and gallblades, vessels. Such structures, as a cyst, bone or concretion, always reflect the waves, it means echopositionitivity (hyperachege).

Increased echoism: What does this mean to the liver parenchyma?

The liver with ultrasound examination is in a state of the norm has an average echogenic rate. Hepatic cells are always rich in water. In pathological changes, instead of water, layers of adipose tissue begin to appear. Such processes are called diffuse changes during which dysfunction starts in the liver.

An increased echogenic rate is subsequently manifested by parenchymal liver changes. The saturation of parenchymathous cells with water ceases as a result of hormonal imbalance, disorders of exchange processes, smoking and improper diet. The ultrasound appears an image of the thickening of the liver parenchyma, this indicates changes in its composition and the presence of fatty mess.

Enhancing liver parenchyma echo

Increased echographic liver density is a pathological change that can occur during inflammatory processes in tissues. This pathology can manifest itself at any age, in rare cases in children under 10 years old.

What is the reason for the emergence of increased echogenicity of hepatic parenchyma?

The increased density of the parenchymal liver cells may occur for the following reasons:

hepatitis, which has a chronic current;
the occurrence of adipose tissue;
cirrhosis of the liver;
excess weight;
the presence of various inflammatory, possibly infectious processes at the time of the examination;
due to the reception of drugs;
tumor changes in the liver;
the occurrence of abscess;
with sugar diabetes;
the hematoma emerged due to the injuries of the abdominal cavity.

Indicators received after the ultrasound may vary at different times of the year, depending on the power mode and lifestyle. And therefore, if the ultrasound is diagnosed with high echogenicity of hepatic parenchyma, the patient prescribe a re-examination after a while.

In a healthy condition, the liver fabric has an average permeability. The increased density of the liver structure is reflected with greater speed, which means changes in the work of the organ. But, based only on the ultrasound, the doctor cannot set the final diagnosis. Therefore, a specialist appoints an additional examination to identify the reasons that provoked pathological processes in the liver.

Symptomatic manifestations of pathological changes in the hepatic fabric:

sometimes pain appear in the right side;
periodic manifestation of nausea, right up to vomiting;
weight gain;
blood test indicators with sugar content and elevated levels of lipids;
the liver is enlarged during palpation;
deviations in the work of the cardiovascular system and the digestive tract;
manifestations of jaggptious symptoms;
low immunity.

Echogenicity of renal parenchyma increased

The renal parenchyma is the surface of the kidney, which consists of a brain and cortical layer in the capsule. Parenchima performs the main functions of the kidneys, and is responsible for the removal of urine. In a healthy condition, the kidney parenchyma is visible with normal echogenicity.

If the study showed high echogenicity of renal parenchyma, there may be causes:

The presence of glomerulonephritis.
Diabetic nephropathy (an increase in the organ in size, but the kidney pyramids will be viewed with a reduced echogenicity).
Inflammatory kidney processes.
Exchange processes can be disturbed, like an endocrine system.

Increased density with ultrasound examination can talk about the presence of carcinoma, kidney infarction. The final conclusion does a urologist or nephrologist.

kidney carcinoma

Reduced echogenicity of hepatic parenchyma

Reduced Echogenic indicator indicates swelling processes and inflammation in the body under study. If echogenicity is lowered in the study of the liver, it can talk about the hepatitis of acute flow.

During the survey, the specialist not only notes changes in liver echogenicity, but also tries to determine what such processes are caused. Also, with ultrasound examination, the condition of the liver vessels and its duct (in what state will their location, location, have seals).

Further actions with increased liver echogenicity

After the study of the body and the conclusion of the increased density of the liver tissue, the attending specialist will send for an additional examination to determine the final diagnosis. The patient needs to go through the following manipulations:

Common blood test: when deciphering, the specialist will focus on leukocyte levels, their increase in blood can talk about the presence of inflammation occurring in the liver; The indicators of platelets are important, the change in which can talk about the reduced functional activity of the organ.
Blood analysis on biochemistry: the most carefully processes the indicators of bilirubin, albumin, alkaline phosphatase.
Duodenal probing (in cases of violation of the choleretic liver function): The surveyed is swallowed by a probe, from there are bile samples.
Pencil of hepatic tissue for histology (with possible tumor processes or hepatitis the extremely severe flow, threatening with the occurrence of cirrhosis).
MRI (can send a patient when diagnosing cysts, abscesses or neoplasms, especially if in a patient who has a change in echogenic, fat and ultrasonic waves may well reflect a picture of the liver status).

What treatment is used with increased liver parenchyma echogenic?

The most important in the treatment of the echo liver density will be healthy and balanced food. Cannot be used the following products: baking from a dough, for example, pies, buns, cakes; Fatty meat and fish; garlic; sorrel; horseradish; canned; Fresh fruits and vegetables; tomato juice; tomatoes; alcoholic beverages; Products from chocolate and soda.

For a healthy nutrition, specialists advise to cook food for a couple, bake in the oven or just boil. It is necessary to use such products: low-fat meat and fish; Rye crackers or bread; fermented milk products, preferably skimmed or with a low fatness percentage; Vegetable soups, you can on meat broth; oatmeal, buckwheat and rice; boiled or paired vegetables; Not often boiled eggs.

Also, the attending specialist can prescribe drugs to eliminate the symptoms of the occurrence of increased echogenicity of the liver. In pain, antispasmodics will be assigned if there are stagnant processes in the liver ducts, the preparations with a choleretic effect, if diuretics are prescribed.

If you need to normalize the exchange processes in the liver cells, hepatoprotectors are used, such as estensial or hepamerts. To improve the processes of supplying nutrients to the liver, assign means to improve the work of disaggregant vessels.

If in the liver discovered inflammation processes, the doctor will definitely assign treatment with antibiotics, to eliminate it. Specific liver treatment is carried out if the patient has hepatitis or cirrhosis. The cause of echo density can be like diseases and an incorrect diet, sharp obesity, or on the contrary, weight loss.

The prevention of liver disease can become healthy eating. The lack of vitamins and microelements negatively affects the work of the liver, and accordingly, negatively affects the entire body as a whole. Since improper nutrition can provoke elevated pairhime performance, experts are recommended to monitor the daily diet for the full work of the liver and other organs.

Changing the echogenicity of the parenchyma of the thyroid gland

If in the conclusion of the thyroid ultrasound of the thyroid gland, elevated indicators of the echogenicity of the parenchyma is indicated, this means a decrease in follicular substances, with the help of which hormones (colloids) appear, it is also possible to calcinate or the appearance of scar tissue tissue. Causes this process endemic or toxic goiter. However, the final diagnosis will be delivered by an endocrinologist.

Changing the Echogenic Indicator in the Spleen

The echographic picture of the spleen in the normal condition is characterized by greater density than in the liver and kidney during ultrasound research. With age, the fabric of the spleen becomes compacted, but still less dense than the pancreas. There are changes in echogenicity due to the processes of increasing pressure in the petrose vein or due to the high amount of iron in the blood. During tumor processes, the ultrasound indicators of the parenchyma do not change, but the spleen will be enlarged.

Echogenicity increased with ultrasound of the chest glands

In the period of menopause and before its onset, the increased echogenicity of the breast is considered the norm. The reason for such indicators is the growth of fat and connective tissue. But the increased echogenicity indicators in young women, they speak of inflammatory processes in the tissues of the authority, about the resulting cyst. With increased echo density, the attending specialist can be directed to an additional examination in order to determine the final disease.

Either organ. Its changes may appear due to various diseases. In most cases, the echogenicity of the organs is reduced due to inflammation or edema. Along with this term in ultrasound diagnostics, the term "echostructure" is also used, which denotes a certain combination of ultrasonic elements. Echogenicity and echostructure of the object is determined by the doctor when comparing the studied structure with the scale level on the ultrasonic monitor.

The echogenicity of the under study depends on its acoustic properties (reflection, sound conductivity, refraction and absorption of sound waves). In turn, they are determined by the morphological structure of the object. The pattern of the relationship between the morphological and ultrasonic structure of the tissue is as follows: the smaller the structure has a fluid, the echogenicity will be higher and, on the contrary, the more it contains liquids, the lower its echogenicity.

Echogenic levels

In the study, ultrasound objects of 4 species are detected: hyperheogenic (with increased echogenicity), isoehogenic (echogenicity), hypo echogenic (with reduced echogenesis) and (echogenicity is absent). The degree of reduction of echogenicity can be divided into pronounced (closer to the anechogenic) and moderate (closer to isochogenic). Hyperehogenic structures do not contain liquids, they have the greatest acoustic density (reflection sound wave) And the lowest sound system. Such elements are visualized by the naked human eye.

The isochogenic fabric corresponds to the unchanged body, as well as neoplasms, since they have almost the same overall tissue cells. A hypoethogenic fabric corresponds to different diffuse pathologies. It is a high-fusion sector, characteristic of certain types of tissue fabric. Isochogenic and hypooehogenic elements can only correspond to cellular structures.

Anechogenic or hydrophilic structures do not have internal echoes. They are represented by objects containing a liquid component (for example, cystic cavities). Anechogenic structures have high visual sensitivity. With changes in the echogenicity of any organ, you must consult with your doctor. Perhaps you have to undergo an additional examination. The sooner the disease is revealed, the more effective there will be treatment.

Pathology	Features
Chronic hepatitis	The homogeneous structure of the liver, echogenicity is raised moderately.
Cirrhosis	On the early stage Diseases liver is increased. In later stages, dystrophy appears with a decrease in size. Inhomogeneous, mosaic type structure. Mixed echogenicity, depending on the localization of the lesion focus.
Dystrophy and steatosis (fat infiltration)	Moderate liver increase. Echogenicity is enhanced with an increase in the intensity of reflection of sound waves from fat inclusions in hepatic cells.
Chronic cholangit	High echogenicity is observed (hyperachege), manifested in a saturated reflection of sound waves from the walls of extended bile ducts.
Alveocococcosis, opistorhoz (glider invasion)	The on-screen picture shows the diffuse enhancement of echogenicity, the vagueness of invasive and healthy tissue, the mesh structure.
Abscess liver	The initial stage of the emergence of the inflammatory process is represented by a small segment of low echogenicity, but as the abscess develops inhomogeneous echo abscess - or lowered or too elevated.