Have you ever wished you could just look inside your body and see what's giving you trouble? Although Superman's X-ray vision was great, today's ultrasounds, X-rays, computed tomography-scan tests (CTs), and Magnetic Resonance Imaging (MRIs) are the next best thing.
Ultrasound can help your doctor diagnose distorted or swollen fallopian tubes, endometriosis, other pelvic problems, and uterine anomalies. Ultrasound bounces sound waves off internal organs or tissues, detecting differences in the density of various tissues. Your doctor can then see whether organs are in the right location and have a normal density.
1 Transabdominal: This is the most common and least invasive approach. Doctors commonly use this ultrasound for obstetrics, but it can also show fibroids, check the position of organs, and give fairly good information on the uterus and other pelvic organs.
1 Transvaginal: This approach uses a probe through the vagina up to the cervix at the top of the vagina, where the abdominal cavity begins. Because the ovaries should be in this location, a transvaginal ultrasound offers a better view for various problems in the ovaries and tubes (especially for an ectopic pregnancy and endometriomas) and in the endome-trial cavity.
Many times a doctor may ask for both kinds of ultrasounds to be sure he doesn't miss anything.
HSGs, SIS, X-rays, and CT scans
Your doctor may suggest a number of additional tests to get a better look at your insides, particularly if you're planning on trying to get pregnant. Some of these tests are more effective than others in diagnosing endometriosis. He may recommend the following tests:
1 Hysterosalpingogram (HSG): In this test, dye is passed through the uterus and the fallopian tubes. Your doctor can tell if your tubes are blocked by adhesions or dilated by inflammation, as well as check for uterine anomalies (see Chapter 7 for more on HSGs and how they're done).
1 Saline Infusion Sonohysterogram (SIS): This test may be done to get a better look at the structure of the uterus and endometrial cavity. The procedure is done with a small tube placed into the uterus (like a very thin catheter) so that saline can be infused into the endometrial cavity while the ultrasound is completed.
1 X-Ray: X-rays are useful for looking at bony structures and some soft tissue, such as the lungs or parts of your abdomen. Unfortunately, an X-ray only tells you whether you have a mass or obstruction in your lungs, bladder, or bowel; it can't diagnose whether the blockage is endometrio-sis or some other kind of mass.
1 CT scan: A computed tomography-scan (or CT), similar to X-rays, can show masses and obstructions as well as cysts, but they can't differentiate between endometriosis and other types of masses. Because they consist of multiple slices of the area, CT scans can give a more distinct image of a body part. This increased resolution can be better than a single, simple X-ray picture.
Magnetic Resonance Imaging (MRIs)
An MRI machine consists of a large tube that you slide into (or are slid into) so that the specific body part is in the exact center of the magnetic field that runs through the MRI. The tube is actually a big magnet. Your doctor can use MRIs to diagnose endometriosis if the lesions are larger than 2 centimeters (about 1 inch) and to diagnose endometriomas (cysts caused by endometriosis). Check out Chapters 3 and 7 for more on endometriomas.
MRIs are very expensive compared to other diagnostic tests but may be useful in distinguishing between certain abnormalities. Although the MRI can't see cysts well, this diagnostic test may help to rule out other problems, such as fibroids or pelvic abnormalities. The MRI has not supplanted the gold standard of a biopsy for endometriosis (refer to the next section).
So how do MRIs work? MRIs use magnets and radio waves to create images. A computer creates the images by sending radio waves through your body and collecting the signal that's emitted from the hydrogen atoms in your cells. An antenna collects this information and feeds it into a sophisticated computer that produces the images. MRIs can show much greater detail in soft tissues (they're not so good with bones) than CT scans. MRIs can also scan from many different angles, but CT scans can only scan horizontally.
The magnets in MRIs are extremely powerful and can attract metal even if the metal's inside you! An MRI isn't for you if you have
1 A pacemaker 1 A cochlear implant 1 Pieces of metal in your eye i Metal clips in your brain or elsewhere 1 Dental bridges i Braces i Belly button rings, toe rings, a pierced tongue, or any other metal decorations or piercings
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