Abnormal uterine bleeding ultrasound

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Ultrasonography, although not the most sensitive or specific imaging modality, is commonly the primary type of imaging done for patients with dysfunctional uterine bleeding. Transvaginal ultrasounds are more accurate compared to pelvic ultrasound, but pelvic ultrasound reveals certain pathologies, including uterine and adnexal masses, more clearly. Ultrasonography is a simple and easily available diagnostic method for PCOS.

Ultrasound Findings
Underlying Cause	Ultrasound Imaging	Findings
Endometrial Polyps^[1]	Case courtesy of Dr J. Ray Ballinger, Radiopaedia.org, rID: 23679	Solitary, homogeneous and echogenic lesion Rarely hypoechoic or heterogeneous May be pedunculated (with a stalk) or broad-based May possibly be surrounded by endometrial fluid
Adenomyosis^[2]	Case courtesy of The Radswiki, Radiopaedia.org, rID: 11170	Linear striations extending from the endometrium into the myometrium An irregular junction between the endometrium and myometrium Subendometrial cysts that measure 1-5 mm in size (specific sign)
Leiomyoma^[3]	Case courtesy of Dr Maulik S Patel, Radiopaedia.org, rID: 12850	Hypoechoic Calcifications present Cystic necrotic areas
Malignancy^[4]	Case courtesy of Dr Aneta Kecler-Pietrzyk, Radiopaedia.org, rID: 53104	Thickened endometrial strip; >5 mm in postmenopausal, >8 mm if currently using hormone replacement therapy or tamoxifen Mass lesion Intrauterine fluid accumulation Invasion of the myometrium
PCOS^[5]	Case courtesy of The Radswiki, Radiopaedia.org, rID: 11803	Enlarged ovaries Multiple follicles present Follicles rang in size; 2-9mm Increased ovarian volume
Endometrial Causes^[6]	Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org, rID: 23580	Unilocular cyst Hemorrhagic debris resulting in diffuse homogeneous ground-glass masses Multiple locules