Local thickening of the myometrium along the posterior wall. Thickening of the intestinal wall on ultrasound

Ultrasound examination (ultrasound) of arteries with high resolution - a convenient non-invasive method for studying the wall carotid artery. The thickness of the intima-media complex (IMC) is currently a sonographic (ultrasound) marker of early atherosclerotic lesions of the vascular wall and not only reflects local changes in the carotid arteries, but also indicates the prevalence of atherosclerosis.

In the structure of acute vascular lesions of the brain, the leading role belongs to ischemic stroke (IS). AT last years The state of IMT of the carotid arteries (general - CCA, and internal - ICA) and the relationship between risk factors for IS and the thickness of the intima-media complex (IMC) of the carotid arteries are being especially actively studied. The greater the thickness of the IMT, the higher the likelihood of developing a transient ischemic attack and IS.

AT recent times there are works demonstrating the relationship between the ever-increasing thickness of the IMT of the carotid artery and the risk of recurrent stroke. So, K. Spengos, G. Tsivgoulis, E. Manios (2003) showed that each increment of 0.1 mm thickness of CCA IMT increased the likelihood of recurrent stroke by 16.5%. There are studies indicating a significant correlation between the thickness of CCA IMT and the severity of cerebrovascular diseases...

Definition. The intima-media complex (IMC) is an arteries detected by ultrasound in healthy person a two-layer structure with a hyperechoic layer adjacent to the vessel lumen and a hypoechoic layer underlying it. With the thickening of the CMM, the differentiation of layers disappears in its image, heterogeneity and surface roughness appear. IMT thickening is predominantly indicative of areas of vascular branching and flow turbulence (eg, internal and common carotid arteries near the carotid bulb, carotid bulb itself, femoral arteries). As research vessels, the common carotid and common femoral arteries are usually chosen, because these vessels are easiest to bring into the desired projection for measuring IMT. Normally, the average this indicator in the common carotid artery is 0.9 ± 0.1 mm, in the common femoral artery - 1.1 ± 0.1 mm.

According to the national recommendations developed by the committee of experts of the All-Russian scientific society cardiologists (2011) take values ​​of more than 0.8 and less than 1.3 mm for an increase in the thickness of the IMT. Local thickening of IMT more than 1.3 is considered evidence of the presence of an atherosclerotic plaque. In some recommendations, it is customary to consider the thickening of the CMM starting from 0.9 mm (see below).

Relevance. AHA (American Heart Association) data suggested that ultrasound carotid arteries is one of the methods for assessing the risk of complications in patients without clinical symptoms, but included in the risk group for cardiovascular diseases, including arterial hypertension. This study can be used in general clinical practice.

Despite the low specificity, the method for detecting brachiocephalic artery stenosis (BCA) in asymptomatic patients (subclinical course of the disease) based on the IMT thickness is quite simple, it is reproducible on relatively simple equipment and does not require high qualification of the researcher. At the same time, the unprofitability and inexpediency of total ultrasound screening has been proven (due to the relatively low prevalence of clinically significant stenoses of the ACA in the population), which determines the need for a staged approach to identifying this pathology. As a first stage for patient selection, it is advisable to use methods that have maximum sensitivity (so as not to miss the pathology), and at subsequent stages - the greatest specificity (to exclude false positive results). The simplest diagnostic tests should be used as such "selection factors". One of these tests is to determine the thickness of the "intima-media" complex of the common carotid artery (IMCCA), since a close relationship has been proven between thickening of the carotid artery wall and the risk of developing cardiac and cerebrovascular complications (the thickness of the CCA IMC is one of the independent risk factors for the development of transient ischemic attacks and stroke).

Anatomy. Human arteries are a three-layer structure consisting of intima (inner shell), media (middle shell) and adventitia (outer shell), between which are the inner and outer elastic membranes. The ultrasound image of the arterial wall structures is based on the difference in the acoustic density of the arterial wall tissues and the reflection of the ultrasound beam from the tissue interface of different ultrasound densities.

The main lesions that occur during atherosclerosis are concentrated in the intima, it is in it that atherosclerotic plaques are formed. The thickness of the intima-media complex (KIM, or IMT - intima-media thickness) - the distance between inner surface intimacy and outer surface copper - is a predictor (early marker) of atherosclerosis (hyperlipidemia) and coronary disease heart disease (IHD), and the thickness of the IMC reflects not only local changes in the carotid arteries, but also indicates the prevalence of atherosclerosis. Also, the thickening of the complex is reliably observed in arterial hypertension, diabetes, in smokers. It is known that the thickness of CCA IMT is one of the independent risk factors for the development of transient ischemic attacks and stroke.

AT latest research it was found that the thickness of the IMT has a pronounced heritability. There are reports of significant relationships between obesity and IMT thickness. It is likely that common genetic factors may partly explain the relationship between these two congenital and inherited traits. Little is known about the genes that affect IMT thickness. According to the results of the study, 3 loci on chromosomes 2, 6, and 13 affect the IMT thickness of the common carotid artery. Among them, the linkage on chromosome 2 has the most significant effect. However, according to recent results from the Framingham Heart Study, a significant linkage with ICA IMT thickness was found on chromosome 12.

CMM Thickness Measurement. It is impossible to measure the thickness of individual CMM layers using modern instrumentation technologies. The measurement is carried out in B-mode ( ) using standard ultrasound machines (with a built-in ECG unit and software for vascular research) at high frequencies (10 - 15 MHz). In 2007, the experts of the European Society for Arterial Hypertension and the European Society of Cardiology selected the following values ​​as the norm: IMT thickness< 0,9 мм, утолщение КИМ - 0,9 - 1,3 мм, а критерием бляшки обозначен КИМ, равный 1,3 мм (т.е. за бляшку принимается фокальное утолщение стенки артерии со стороны просвета высотой >1.3 mm).

However, numerous studies have shown an increase in IMT thickness with age. According to the Russian Medical Society for Arterial Hypertension and the All-Russian Scientific Society of Cardiologists (2008), in healthy individuals under 30 years of age, the IMT thickness (OCA) is 0.52 ± 0.04 mm, from 30 to 40 years - 0.56 ± 0.02 mm, from 40 to 50 years old - 0.60 ± 0.04 mm, over 50 years old - 0.67 ± 0.03 mm. In women before menopause, the thickness of the IMT is less than in men; after the termination of the protective effect of estrogen on the vascular wall, the thickness of the IMT in women and men is gradually compared. Thus, the use of a single threshold value of 1.0 mm (as previously suggested) or even 0.9 (as suggested by the European Society of Cardiology Guidelines for the management of patients with arterial hypertension) seems inappropriate. Of great interest are studies that provide a more detailed, by quartile, gradation of normal values. IMT thickness values ​​greater than or equal to the 75th percentile for their gender and age group are defined as significantly high and predict an increased risk of developing cardiovascular disease(CVD) in a patient of a given gender and age. Values ​​between the 75th and 25th percentiles are average and do not change the Framingham risk score for CVD. Values ​​less than or equal to the 25th percentile are associated with a low risk of developing CVD (see below). table), but it has not been shown whether their detection reduces the activity therapeutic tactics patient management. Before the publication of such data on the Russian population, it is proposed to use the threshold value of the IMT thickness (TCA) for men and women under 40 years old - 0.7 mm, for men from 40 to 50 years old - 0.8 mm, over 50 years old - 0.9 mm , for women 40 - 60 years old - 0.8 mm, over 60 years old - 0.9 mm. Although thickening of the IMT of the common femoral arteries is also one of the indicators of the risk of developing cardiovascular complications, only a few works of foreign authors are devoted to studying the thickness of the IMT in both adults and children.

According to the national recommendations of the All-Russian Scientific Society of Cardiology (2011), the standard protocol for measuring the thickness of the CIM includes measurements at three levels of the vascular bed and bilaterally: at the proximal, medial and distal points for 1 cm from the bifucation along back wall common carotid artery (as the most distant from the sensor). IMT thickness is defined as the distance between the first and second echogenic line of the located vessel according to the Pignoli and Salonen technique. The first line represents the boundary between the vessel wall and its lumen, and the second line represents the collagen layer along the edge of the adventitia. Further, the average thickness of the CMM is calculated as the average of all 12 measurements. The reproducibility of this index reaches 95%. A high resolution sensor (7.5 MHz) is used.

CMM thickness measurement can be performed in manual (manual), semi-automatic and automatic modes. When measuring by the operator (in manual mode), the cursors of the ultrasound system are used, while the first cursor is set to top edge the first echo-positive line (at the border of the vessel lumen - intima), the second cursor - along the upper edge of the second echo-positive line (at the border of the media - adventitia). To improve the accuracy of measuring the thickness of the CIM, it is preferable to use automatic or semi-automatic modes, which involve automatic contouring of the lines of the section "arterial lumen - intima" and "media - adventitia" (the doctor only needs to display the projection of the vessel and place the frame on the vessel wall, the device will automatically contour the intima, media and calculate the maximum, minimum, and average CMM thickness values).

Many modern expert ultrasound systems are equipped with an additional software algorithm for automatic measurement of the CCM CCM thickness. There are also separate programs that allow automatic and semi-automatic assessment of the CCA image obtained using any device. All these programs allow for very a short time (< 0,1 с) провести до 150 измерений толщины стенки на протяжении 1 см, посчитать среднее значение, выбрать максимальное значение толщины КИМ. В полуавтоматическом режиме оператор имеет возможность внести свои коррективы в измерения, выполненные прибором. Следует подчеркнуть, что при наличии атеросклеротической бляшки в исследуемой зоне ее поверхность не включается в контур. Компьютерные методы оценки значительно более воспроизводимы (при good quality image) compared to the manual method for assessing CMM thickness.

To obtain reliable CMM measurement results, a number of provisions must be observed. The recommendations of the American Society of Echocardiography (2008) for the study of IMT thickness have been published, which list the necessary requirements for equipment, personnel, methods of conducting and interpreting the results of the study. For example, it is proposed to use only the measurement of the thickness of the CMM of the back wall of the OCA. Visualization of the posterior wall in the distal third of the CCA is possible in almost 100% of cases (whereas high-quality visualization of the structure of the wall of the internal carotid artery is available only in 50 - 88% of cases), here the artery is located close to the skin surface, parallel to it, and almost perpendicular to the ultrasound beam , which ensures high reproducibility of CMM measurements in this area.

Additional Information:

1 . [read] Review modern techniques early diagnosis atherosclerosis [+ video: what automatic measurement of the thickness of the intima-media complex looks like];

2 . [read ] Ultrasonic Methods assessment of the thickness of the intima-media complex of the arterial wall;

3 . [read] Determining the thickness of the intima-media complex for screening for carotid stenosis;

4 . [read] Cardiovascular prevention (National recommendations Developed by the Committee of Experts of the All-Russian Scientific Society of Cardiology).

© Laesus De Liro

Wall thickening Bladder is a frequent occurrence accompanying urolithiasis. It is possible to establish such a pathology only with the implementation of an ultrasound examination.

Taking into account the fact that the thickening of the bladder wall is not an independent pathology, but only its separate part, a specialist can refer the patient to an ultrasound if there are symptoms characteristic of violations of the urinary system. In the process of conducting such a diagnosis, the doctor can determine the underlying pathology, as well as identify the process of compaction of the walls of the urinary organ.

Complaints

The main reason for referring the patient to an ultrasound scan is his complaints and the symptoms listed by him, indicating the development of the pathological process.

Frequent urge to urinate with sharp pains and pains in the lower abdomen, may be manifestations of the inflammatory process. Stone advancement, oncological formation can also cause the occurrence similar symptoms.

signs

Hematuria is one of the signs of bladder wall thickening, which should alert the patient. At the same time, urine acquires a red tint, when the bladder is emptied, pronounced cramps and burning are felt.

It should also be alert that at the time of urination, the patient feels that the bladder has not completely emptied.

If during the laboratory research urine protein or an increased number of leukocytes was detected, the urologist in without fail refer the patient for diagnostic testing.

Thickening of the bladder wall is divided into local and diffuse, each of which has a characteristic cause.

diffuse seal

This type of pathological process can provoke inflammation or a sudden increase in the load on the muscle layer of the organ. The bladder is a hollow muscular organ whose main function is to hold urine. The process of urination occurs in such a way that when the bladder is filled, its nerve endings are irritated, after which a signal is transmitted to the brain about the need to empty it. Muscles begin to contract, which contributes to the excretion of urine. In urolithiasis, a stone can block urine output. In this case, the muscle layer of the bladder will continue to contract in order to remove it, despite the obstacle. Frequent and prolonged muscle tension contributes to an increase in muscle volume, and subsequently leads to a thickening of the walls of the bladder.

A tumor neoplasm can also block the ducts in any part of the urinary system. The thickening of the bladder wall is observed due to violations of its work in size, which provokes the process of squeezing the urethra, blocking the normal outflow of urine. If a thickening of the bladder wall is found in men, a specialist should examine prostate and prescribe treatment.

Inflammation of the bladder can also cause thickening of its walls. That is, a common cause of this pathology is cystitis. The urinary organ is exposed this disease as a result of severe hypothermia, the presence of infection, trauma to the mucous membrane of the organ. Infection is the main cause of the development of this pathology. Penetrating into the cavity of the bladder, it affects the submucosal and mucous layers. This contributes to the development of serious pathological changes that lead to thickening of the bladder walls.

Local seal

Local compaction does not extend completely to the surface of the muscular layer and the mucous membrane of the bladder, but only to a certain part of the organ.

The cause of this pathological process is a hereditary factor, especially in situations where a patient has a specific structure of an organ that differs from the standard one.

However, a local variety of the disease can be acquired in the course of life. Any injury to the bladder can affect the structure of the walls, provoke the development of a hematoma, and further lead to a thickening of its walls.

A benign or malignant neoplasm, polyps, papillomas during ultrasound appear in the form of a hyperechoic formation in the bladder, which may also be indicated by the entry of a kidney calculus into the bladder.

Specific visual signs may be absent, so determine this pathology a specialist can only after a diagnostic examination.

Why does the bladder wall thicken in women?

Causes

Even a slight compaction of the walls is caused to the greatest extent by a variety of inflammatory and infectious processes. It is much easier for all bacteria and other infections to enter the bladder of women, since the length urethra they have slightly less than men. Therefore, this pathological condition is observed mainly in them. In addition, the disease often develops in those patients who have low sexual activity. And finally main reason bubble wall compaction is urolithiasis disease.

Thickening of the walls of the bladder in a child can also be detected. Symptoms need to be identified in a timely manner, because children often cannot talk about what is bothering them. After all, the child may not even feel discomfort.

Diagnostic measures

Due to the fact that the compaction of the muscle layer cannot be attributed to the category of major pathologies, but only to their clinical manifestation, specialists direct their actions to determine the true disease in order to prescribe drug therapy in the future.

Ultrasound is considered the fundamental method for diagnosing such phenomena and allows you to establish urological pathologies that pose a danger to the bladder. For a complete this study The patient is advised to drink plenty of water before the procedure. It is extremely important that the bubble is filled with liquid as much as possible. In this case, the specialist will be able to detect any pathological formation, establish its localization and degree of risk.

In addition, such a study helps to determine the size of the organ, and with developing pathological processes, the small size of the bladder is often observed, which is unable to hold a large amount of urine, as a result of which the muscles have to stay in constant voltage. This provokes a thickening of the walls of the bladder.

Treatment

Therapeutic assistance in the development of such a condition depends on the causes of its occurrence. At inflammatory diseases that caused the seal, the following drugs are used:

• antibacterial - "Ciprofloxacin", "Amoxicillin", "Ceftriaxone", "Levofloxacin";
• antispasmodics - "Papaverine" "No-shpa";
• NSAIDs - Ibuprofen, Indomethacin, Meloxicam.

In the case when hypertrophy has arisen due to injury or hereditary factor, treatment usually involves surgical intervention. Separately, therapy is determined in the case when the cause of the pathology is urolithiasis. The method of removing a calculus depends on its size, type and location. Small stones are removed with antispasmodic medications that dilate the urinary tract. For large stones, ultrasonic crushing or surgical removal is used.

The oncological etiology of the development of seals in the bladder requires combined treatment: chemotherapy, surgery and radiation therapy.

If prostatitis has become the cause of hypertrophy, or assistance is directed primarily to the treatment of the underlying disease, and then to the bladder. The causes and treatment of bladder wall thickening are interrelated.

Recovery

After therapeutic measures a recovery process begins, in which some medical preparations or physiotherapy. These include:

• antibiotics;
• immunotherapy;
• prostate massage;
• physical exercise;
• rejection of bad habits.

ethnoscience

Traditional medicine can also help, for example, an infusion of mint, a decoction of dandelion roots, a carrot decoction, an infusion of celandine, aloe, etc. Such remedies are prepared according to special recipes.

We looked at the causes of thickening of the walls of the bladder.

In the myometrium, local thickening can be both on the front wall and on the back. Why is this factor dangerous for pregnancy, and what are the permissible deviations?

Why does the myometrium thicken

In some pregnant women, during diagnostic tests thickening of the myometrium. In gynecology, the muscular layer of the uterus is called the myometrium. Its thickness varies depending on the stage at which menstrual cycle there is a woman, or during pregnancy. In order to prevent the development of pathological processes, you need to know what caused the thickening of the myometrium.

Quite often, local thickening occurs on the anterior wall of the uterus. It's connected with hormonal disorders or gynecological, obstetric and even endocrinological diseases of a woman.

Changes can be detected during menstruation, which gradually disappears. The level of progesterone and estrogen changes, which contributes to normal fluctuations in the thickness of the myometrium. Thus, the 2nd phase of the menstrual cycle can affect the local thickening of the myometrium up to one and a half centimeters, and at the end of the menstrual cycle, the thickness can be only a couple of millimeters.

The myometrium can also thicken in connection with the gestational age. This is due to the fact that the fetus increases, hormonal and physiological changes occur. With the help of ultrasound, it is possible to detect not only normal thickening, but also to identify pathologies such as:

• uterine myoma;
• the threat of termination of pregnancy;
• adenomyosis;
• endometriosis.

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Why there is a threat of termination of pregnancy

After an ultrasound examination performed in the first trimester of pregnancy, the specialist registers a local thickening of the myometrium along the anterior wall of the uterus. O pathological disorders thickening indicates after 5 weeks, before this period, thickening indicates implantation gestational sac which is not a pathological process.

The threat of termination of pregnancy may arise due to the following reasons:

• if the embryo has a drop-shaped or navicular shape;
• if the uterus is in a state of hypertonicity;
• if the external contours of the uterus are greatly changed.

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Adenomyosis and endometriosis

Quite often when inflammatory processes adenomyosis develops in the uterus. With this disease, the endometrium is able to grow into the layers of the walls of the uterus. This disease can be detected in the presence of such signs as: spotting type discharge; menstrual irregularities; the presence of pain; during the study, both local and posterior can be detected. Adenomyosis is a form of endometriosis, subject to significant violations of the muscular layer of the uterus.

The endometrium is the lining of the uterus. In inflammatory processes, endometrial cells are disrupted, and endometriosis develops. Previously medical specialists believed that this ailment is a sign of some gynecological diseases. modern medicine it was singled out as an independent nosological unit. One of the forms of this disease is, which indicates the location of inflammatory foci in the thickness of the endometrium. With endometriosis, local thickening of the myometrium along the back wall is often detected. This form of thickening can lead to the development of malignant neoplasms of the uterus. In this case, not only thickening is observed, but also a pronounced asymmetry of the uterus due to the development of a focus in its wall.

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What causes uterine hypertonicity

Hypertonicity of the uterus during pregnancy requires maximum attention. This is due to the fact that the fetus needs a normal supply of nutrients and oxygen. This significantly affects the further outcome of pregnancy. Most often, hypertonicity is accompanied by vascular compression, and the significance of these vessels lies in the fact that they contribute to the nutritional and oxygen supply of the fetus. This factor adversely affects the fetus. However, not always due to being provoked premature birth or miscarriage.

What are the reasons for development? Often these factors are:

1. When hormone levels drop. This condition is especially dangerous for pregnancy for up to 10 weeks. This is due to the fact that the placenta is only being formed during this period.
2. With an increase in the level of androgens, the myometrium lends itself to hypertonicity.
3. Diseases transferred during pregnancy. Tumors, inflammations, abortions and infectious diseases are also the cause of an increase in the tone of the uterus.
4. Multiple external factors also affect myometrial tone. These include malnutrition, lack of sleep, alcoholism, smoking, or constant anxiety.
5. Another factor in hypertonicity of the myometrium is the underdevelopment of the uterus or its small size.

How to properly prevent myometrial hypertonicity is a question of interest to many pregnant women.

In order to prevent such a condition, even when planning a pregnancy, a woman should be fully examined for everything infectious diseases and eliminate existing ones.

Infections during pregnancy are fraught not only with hypertonicity, but also with much more dangerous effects (during childbirth, a child can acquire many rather unpleasant diseases that cause blindness or even death). In addition to hypertonicity, there is also a state of uterine hypotonicity, which during pregnancy may not cause any inconvenience, but problems may arise during childbirth.

During pregnancy, a woman should be as nervous and physically overstrained as possible. She better learn not to worry. When the first signs appear increased tone myometrium should not panic, but consult with an endocrinologist and gynecologist.

Do not think that thickening is a consequence of factors only the threat of pregnancy, often the cause can be a hormonal surge that remains within the normal range. being corrected hormonal background when visiting a gynecologist or endocrinologist. These doctors prescribe proper treatment, thanks to which a woman can not worry about pregnancy.

All layers reproductive organ the women that make up its wall are responsible for a certain role in the process of growth and development, life and disease in women. The endometrium is the inner proliferative layer that lines the uterine cavity. Hormonal cycle, its phase determines the degree of thickening of the endometrium. It is also important to recall here why this layer of the uterine wall thickens.

The most important moment is pregnancy. The fertilized egg moves along fallopian tubes into the cavity of the organ, where the thickened inner layer is already ready to receive it for the further development of pregnancy. The fetal egg is attached to the anterior wall, the localization of the place of attachment of the egg on the posterior wall is considered more favorable.

Thickening of the myometrium during pregnancy is normal. Since in order to endure pregnancy, then give birth to a child, a sufficiently powerful muscle mass is needed for the uterus. Therefore, during pregnancy, there is a thickening of the myometrium of the entire uterus or local thickening muscular wall. It should be noted that local thickening is normal only up to a short gestation period, up to about 5 weeks. Further growth process muscle mass uterus should occur evenly throughout the organ. One should be very attentive to such a factor, since the expression: “a disease is easier to prevent than to treat” must always be remembered.

Local thickening of the myometrium may be due to several factors:

• Pregnancy up to 2 months can be considered a variant of the normal development of pregnancy;
• The hormonal status of a woman. The examination can be repeated or carried out on another day of the cycle to exclude the disease;
• Pregnancy after 6 weeks, proceeding with pathological abnormalities: threatening to terminate the pregnancy for early dates, For example.
• Various diseases of the uterus. These include pathological conditions such as endometriosis, adenomyosis, endometritis, fibroids.

In the first few weeks of pregnancy, it is more often possible to observe a local thickening of the myometrium of the anterior wall of the uterus. This condition does not declare a disease, it only indicates that the pregnancy has taken place, and the fertilized egg has begun to consolidate in the thickened inner layer of the uterus. Further, this local thickening of the myometrium of the anterior wall or posterior wall of the uterus, in the normal course of events, should disappear, and the myometrium will proliferate evenly.

threatened miscarriage

With the threat of miscarriage (miscarriage) for more later dates, thickening of the myometrium both on the anterior wall and on the posterior wall of the uterus, as a rule, is combined with uterine hypertonicity. The ultrasound picture of myometrial hypertonicity is characterized by the following factors:

• Local thickening of the myometrium is clearly visible against the background pathological form embryo;
• Often there is a violation of the contour of the uterus along the outer line - part of the wall is raised;
• On the back wall of the uterus, a local thickening of the myometrium is clearly recorded.

Complementary ultrasound data with factors that indicate the presence of a threat to pregnancy and hypertonicity (pathological tension of the muscular skeleton of the uterine wall) are also subjective complaints of a woman:

1. Frequent pain in the lower abdomen of a aching nature.
2. Often pain in the lower abdomen is accompanied by soreness of the sacrum and lumbar back.
3. The discharge from the vagina that appeared against the background of these pains: bloody or streaked with blood.

Hormonal changes

Local thickening of the uterine wall (myometrium) is often seen in middle-aged women. This is about 30 to 45 years old. The hormonal landscape changes with the course of life, additional diseases, surgeries or pregnancies. All these factors leave traces in muscle layer in the form of small local thickenings. They have a nodular structure, the location can vary and are found throughout the body of the uterus: on the back wall, anterior wall or in the upper part of the uterus. The factor of changes in the intensity of hormone secretion and changes in their ratio depending on the age of the woman must be taken into account and regularly observed by a specialist. This is necessary in order to possible growth nodes in the anterior or posterior wall of the uterus in time to notice the development of fibroids.

Myoma

The degeneration of nodular local thickenings into a muscular tumor of the uterus is quite easy to notice with an objective examination. The surface of the uterus becomes noticeably bumpy, uneven. These formations are quite recognizable on palpation. The woman's organ loses its symmetrical structure, as there is an uneven thickening of either the posterior wall or the anterior wall, often these changes are local.

Endometriosis of the body of the uterus

Internal endometriosis (adenomyosis) is the most common localization of endometriosis. Clinical manifestations endometriosis of the body of the uterus differ depending on the degree of spread of the process in the myometrium. It is usually customary to distinguish the main forms of the disease:

1. Diffuse form;
2. Focal or nodular form.

When a woman is ill, she complains of bloody issues outside of menses. The menstruation itself is so plentiful that it can acquire the character of hemorrhage, accompanied by painful sensations.

The nodular form of the disease is characterized by almost the same subjective complaints, but an objective examination reveals numerous local thickening of the myometrium, the uterus is sharply painful on palpation.

Other diseases of women characterized by local thickening of the myometrium can be:

• - inflammation of the inner lining caused by infectious agents;
• Tumor formations of various etiologies. These can be benign formations along with malignant ones.

Forecast

The detection of a local thickening of the uterine wall (myometrium) in itself is not necessarily a sign of pathology, but in combination with the above factors, it can pose a serious threat to a woman's health.

In order for a woman to feel healthy, it is necessary to regularly observe a gynecologist for preventive measures. This should be done at least 1 time for 6 months, even without any complaints. If there are any signs of the disease: pain, discomfort, itching, discharge, bleeding outside of menstruation, then this is definitely a reason to see a doctor immediately!

The muscular layer of the uterine wall is called the myometrium. AT various stages menstrual cycle and during pregnancy, its thickness may vary. At the same time, it is important to determine true reason thickening, so as not to miss the beginning of the development of a dangerous pathological process in the body. A common symptom in women is a local thickening of the myometrium along the anterior wall of the uterus. Possible changes in the thickness of the uterine wall may be associated with the hormonal status of the woman at the time of the study and other factors that do not always indicate the presence of the disease.

Possible causes of changes in the thickness of the myometrium

At its core, thickening can be both a gynecological indicator and an obstetric one. And even endocrinology sometimes takes place in the development and symptoms of local thickening of the myometrium.

So, thickening is observed during menstruation, and in the subsequent stage of endometrial proliferation, it disappears. Such fluctuations are the norm, because they are directly related to changes in the level of progesterone and estrogen in female body. For example, at the onset of the second phase of the menstrual cycle, the thickness of the myometrium can be 10-14 mm, while after the end of menstruation it is already equal to 1-2 mm.

It is clear that during pregnancy, the thickening of the myometrium increases in proportion to the duration of the pregnancy itself. This is due to a general increase in the volume of the organ where it develops future baby, with physiological changes in accordance with the hormonal background and fetal growth.

Thickening of the uterine wall is an ultrasound indicator and, in addition to physiologically normal thickening during pregnancy, can be detected in the following pathological conditions:

• The threat of termination of the state of pregnancy
• Uterine fibroids at any stage
• Adenomyosis
• endometritis of the uterus.

Let's take a closer look at these pathologies.

Threat of abortion

According to objective data, ultrasound in the early stages of pregnancy (in the first trimester) reveals a local thickening along the anterior wall of the uterus. If this symptom is detected at a gestational age of up to five weeks, then this is not a pathology and only indicates that the implantation of the ovum and its immersion into the wall has occurred.

If, in addition to thickening, hypertonicity of the uterus and a scaphoid or drop-shaped form of the embryo (which in itself is a pathology) are detected, as well as a visible change in the outer contour of the uterus - its elevated section of the uterine wall above a flat surface, then they talk about the existing threat of termination of pregnancy.

The same can be said if the same local thickening of the myometrium is found along the posterior wall of the uterine fornix. However, ultrasound data must also be confirmed by an objective study of the woman's condition and reliable clinical indicators - nagging pain in the lower abdomen and lower back, bloody discharge, as well as the detection of an additional area of ​​subarachnoid hematoma during the study. Such a hematoma is formed due to detachment of the fetal egg.

uterine fibroids

About uterine fibroids is described in the video:

In every third woman older than 30 years, myomatous nodules are detected in the uterus. Having different sizes and shapes, they are located in the walls, in the bottom and in the dome of the organ. In the body, these nodules are located along the anterior and posterior walls of the uterus. At the beginning of atypical growth of myomatous nodes, ultrasound clearly reveals a local thickening of the uterine wall.

When fibroids are examined, a bumpy and tense surface is determined, sometimes local seals are found. Palpation also manages to detect that the thickened posterior wall of the uterus (or anterior) creates an asymmetry of the organ.

Adenomyosis of the uterus

Adenomyosis is a common case of uterine inflammation in which the endometrium grows into other layers of the uterine wall. Along with such symptoms of adenomatosis as spotting, irregular menstruation, pain, the examination also reveals a thickening of the uterine walls, including the posterior wall of the uterus. And, although the term “adenomatosis” is registered in the international histological classification, it can still be regarded as one of the forms of endometriosis, when there are serious changes in the muscular layer of the uterus.

endometriosis

There is no single answer to the question of what endometriosis is. The endometrium is the inner layer, the lining of the organ wall. Inflammation and morphological changes in the structure of endometrial tissue are called endometriosis. Until recently, endometriosis was considered a manifestation of various diseases genital organs in women, and only recently it was isolated as an independent nosological unit. Despite its widest distribution among women, there are still many blank spots for gynecologists in this disease.

More about this disease is discussed in the video:

One form of this disease is internal endometriosis- indicates that the foci of endometriosis are located in the thickness of the endometrium. Common symptom such a condition is a local thickening in the area of ​​\u200b\u200bthe location of the nodes of endometriosis along the back wall. Also lead to local thickening malignant neoplasms in the uterine cavity. In this case, in addition to the area of ​​thickening, the asymmetry of the organ becomes apparent due to the development of a tumor in one of the walls of the organ.

As a result, we can say that even if there is an established local thickening of the myometrium, there is no need to think about bad forecasts. All the fault may be the usual hormonal surge, not beyond the scope of physiology. By visiting a gynecologist or endocrinologist, most often it is possible to correct the hormonal background of a woman and, thereby, save her from unreasonable fears.