A very common, safe and painless procedure which provides a lot of useful information is pelvic ultrasound (ultrasonography or sonography) A pelvic ultrasound is performed either abdominally or transvaginally (through the abdomen or through the vagina). The ultrasound technician places a probe which transmits sound energy through the body onto the abdomen or into the vagina. The sound waves produce a 2 dimensional image of body fluids and masses. A pelvic ultrasound can provide an exact measurement of different structures and more importantly, determine exact location of fibroids in many cases. Adenomyosis, if present, is often seen during a sonogram. Usually pelvic ultrasound is the first step in diagnosing uterine disease. Sometimes the radiologist will perform a saline hysterosonogram in order to visualize the uterine cavity more effectively. This involves the instillation of saline into the uterine cavity during the ultrasound exam.

There is no preparation for this procedure. It can be performed at any time during a woman’s menstrual cycle and takes about 30-45 minutes. A written report is sent to the ordering physician within a few days.

In some cases, MRI (Magnetic Resonance Imaging) is performed. It is also safe and painless. It provides a 3 dimensional image of the pelvis which might be useful when more than one disease exists (for example adenomyosis and endometriosis). MRI provides accurate information regarding the blood flow within the pelvis which may be of benefit if women are considering uterine artery embolization.

For this procedure, women need to be fasting for 4 hours and a small intravenous is inserted to provide a contrast material. This contrast material helps to enhance the images. Some people are allergic to this contrast material. The test takes about 1 hour and the report is sent to the ordering physician in about a week.