What does vascular mass in a transvaginal ultrasound mean?

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You have a radiologist responding to your query. Please begin with your details on transvaginal ultrasound and the results you got. Thanks.

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Thanks for sharing the TVS (transvaginal sonography) reports and images (attachments removed to protect the patient's identity). I hope you are not in much discomfort. Answering your queries,

1. The previous TVS scan report does not show any significant abnormality in the endometrial cavity or uterus. However, in the scan done later, an endocervical lesion appears to be well-circumscribed and seen to occupy the lumen of the endocervical canal. It shows few tiny cystic changes or fluid spaces within. The lesion in the report is mentioned as vascular, but supporting images showing vascularity or blood flow are not enclosed. Therefore it is difficult for me to comment on the vascularity from the given images accurately. This lesion could be either a polyp arising from the cervix or the endometrium. Since you are complaining of post-coital bleeding, it needs detailed investigation with higher imaging modalities like MRI (magnetic resonance imaging) to visualize the extent and characterization of the lesion's origin and nature. I recommend further consultation with your gynecologist is recommended, who can do a local examination and provide clinical input on nature and management.
2. In reply to the difference in the findings between two scans done 15 months apart, it is possible that the lesion might have been tiny in size to be picked up on a scan previously and has now grown over the period to the current size and is well visualized on ultrasound scan. There are certain technical limitations in doing scans, and 15 months is a reasonable time to allow for significant change in size or a new condition to develop.

Regards.

Hi,

Welcome back to icliniq.com.

The size of the uterus in both reports are within normal limits for your age. The mild variation in length given as 69 mm in the previous scan and 90 mm in the present scan can be due to operator variability or can be due to technical differences in measurement if one was measured in TAS (transabdominal sonography) scan, and the other was in TVS scan. The growth of polyp also causes a bulky cervix, thereby increasing the size of the uterus in totality. Endometrial thickness is also within normal limits for a menstruating woman. The endometrial thickness depends on the hormone levels and gradually increases through the cycle till menstruation. So the sonologist has to correlate the endometrial thickness with the menstrual cycle phase in an individual. I understand that the sonologist has confirmed the stage of your menstrual cycle and therefore mentioned it as within normal limits.

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