Fat Necrosis on Ultrasound: A Patient Guide

Fat necrosis, often presenting as palpable lumps, may necessitate imaging techniques like ultrasound for accurate diagnosis, especially after events such as trauma or surgical procedures. The American College of Radiology (ACR) provides guidelines that often recommend ultrasound as a primary imaging modality for evaluating such lesions. The characteristics of fat necrosis on ultrasound can vary, sometimes mimicking malignant masses, thus requiring careful interpretation by a radiologist experienced in sonography. The role of elastography, a specialized ultrasound technique, is increasingly important in differentiating fat necrosis from other breast lesions, and is a valuable tool for breast imaging.

Fat necrosis is a benign condition characterized by the death of fat cells. This localized process typically results from injury or insufficient blood supply to fatty tissue. While it can occur in various parts of the body, it is most commonly observed in the breast and subcutaneous tissues.

The Importance of Accurate Diagnosis

The clinical significance of fat necrosis lies in its ability to mimic malignant lesions on physical examination and imaging studies.

Distinguishing fat necrosis from breast cancer is paramount to avoid unnecessary anxiety, invasive procedures, and overtreatment. Accurate diagnosis relies on a combination of clinical assessment, imaging techniques, and, in some cases, biopsy.

Common Locations and Predisposing Factors

Fat necrosis can manifest wherever there is adipose tissue, but certain locations are more frequently affected.

• Breast: Often associated with prior breast surgery, trauma, or radiation therapy.

• Subcutaneous Tissue: May occur following injury, injection, or panniculitis (inflammation of subcutaneous fat).

Several predisposing factors increase the risk of developing fat necrosis:

• Trauma: Blunt force or injury to fatty tissue.
• Surgery: Particularly breast surgeries like lumpectomy or reduction.
• Radiation Therapy: Can damage fat cells in the treated area.
• Large Breast Size: Potentially due to increased susceptibility to trauma or poor blood supply.
• Weight Changes: Rapid weight loss or gain may contribute.

The Multidisciplinary Approach

The diagnosis and management of fat necrosis typically involve a collaborative effort from various medical professionals.

• Radiologists play a crucial role in interpreting imaging studies.
• Surgeons may perform biopsies or excisions when necessary.
• Pathologists provide definitive diagnoses through microscopic examination of tissue samples.
• Referring physicians such as primary care doctors or gynecologists help to identify, assess, and refer relevant cases.

This multidisciplinary approach ensures accurate diagnosis and appropriate management strategies tailored to each patient's specific circumstances.

Fat necrosis is a benign condition characterized by the death of fat cells. This localized process typically results from injury or insufficient blood supply to fatty tissue. While it can occur in various parts of the body, it is most commonly observed in the breast and subcutaneous tissues.

The Importance of Accurate Diagnosis The clinical significance of understanding how fat necrosis develops lies in its ability to mimic malignant lesions, particularly in the breast. Misdiagnosis can lead to unnecessary anxiety, invasive procedures, and inappropriate treatment strategies. By understanding the underlying etiology and pathophysiology, healthcare professionals can more accurately differentiate fat necrosis from cancerous growths, ensuring appropriate patient management.

Etiology and Pathophysiology: Unpacking the Development of Fat Necrosis

Fat necrosis arises from a complex interplay of cellular events initiated by injury or ischemia. Comprehending these mechanisms at a cellular level is crucial for accurate diagnosis and differentiation from other conditions.

Cellular Mechanisms of Fat Necrosis

At the core of fat necrosis is the death of adipocytes, the specialized cells that store fat. This cellular demise, known as adipocyte necrosis, is triggered by various insults.

These insults include physical trauma, surgical interventions, or radiation exposure. Regardless of the initial trigger, the downstream effects converge on the disruption of adipocyte integrity.

This disruption leads to the release of intracellular lipids. These lipids then incite a cascade of inflammatory responses.

Association with Trauma, Surgery, and Radiation

Trauma, whether blunt or penetrating, can directly damage adipose tissue, leading to cell death.

Surgical procedures, particularly those involving breast reconstruction or cosmetic alterations, inevitably disrupt blood supply to some areas, predisposing them to necrosis.

Radiation therapy, often used in cancer treatment, can also damage fat cells directly or indirectly through vascular injury.

Scar tissue formation post-surgery can also contribute to fat necrosis by compressing blood vessels and reducing perfusion to the surrounding adipose tissue. This ischemic injury leads to cellular damage.

Adipocyte Necrosis and the Inflammatory Response

The death of adipocytes unleashes a potent inflammatory response. This is characterized by the infiltration of immune cells, primarily macrophages.

Macrophages engulf the released lipids in a process known as phagocytosis.

These lipid-laden macrophages, often referred to as foamy histiocytes, are a hallmark of fat necrosis under microscopic examination.

Giant cells, formed by the fusion of multiple macrophages, may also be present. This amplifies the inflammatory milieu.

This inflammatory response, while initially intended to clear debris, can contribute to further tissue damage and perpetuate the necrotic process.

Oil Cyst and Calcification Formation

As the inflammatory response subsides, the body attempts to encapsulate the necrotic tissue.

This encapsulation often results in the formation of oil cysts. These are fluid-filled cavities containing liquefied lipids.

Over time, these oil cysts may undergo calcification. This leads to the formation of hard, palpable nodules that can be easily detected on imaging studies.

The dystrophic calcification represents the body's attempt to wall off and stabilize the necrotic area, preventing further inflammation or spread.

Clinical Presentation: Recognizing the Signs of Fat Necrosis

Fat necrosis is a benign condition characterized by the death of fat cells. This localized process typically results from injury or insufficient blood supply to fatty tissue. While it can occur in various parts of the body, it is most commonly observed in the breast and subcutaneous tissues.

The Importance of Accurate Diagnosis

The clinical significance of fat necrosis lies in its ability to mimic malignant lesions, particularly in the breast. Therefore, understanding its typical presentation is crucial for accurate diagnosis and appropriate patient management.

Common Symptoms and Sensations

Patients experiencing fat necrosis may report a variety of symptoms.

These symptoms can range from mild discomfort to noticeable physical changes.

Pain, tenderness, or a vague ache in the affected area is not uncommon.

Firmness or hardening of the tissue may also be present, signaling an underlying change.

The sensations can vary significantly from person to person, highlighting the subjective nature of the condition.

Palpable Masses and Lumps

One of the most frequent presentations of fat necrosis is the presence of a palpable mass or lump.

In the breast, this can understandably cause significant anxiety due to concerns about breast cancer.

These masses are often described as firm, irregular, and sometimes fixed to the surrounding tissue.

Their size can vary, and they may or may not be associated with pain or tenderness.

The location and characteristics of the palpable mass are critical factors in the diagnostic process.

Asymptomatic Detection: Incidental Findings

Importantly, fat necrosis can also be asymptomatic, meaning it causes no noticeable symptoms.

In such cases, the condition is often detected incidentally during routine screenings, such as mammograms or ultrasounds performed for other reasons.

These incidental findings underscore the importance of regular screening, even in the absence of symptoms.

This is especially true for individuals with risk factors for breast disease.

The Crucial Role of Medical History

A thorough medical history is paramount in the evaluation of suspected fat necrosis.

Prior surgeries, particularly breast surgeries, such as lumpectomies or breast reductions, are significant risk factors.

Trauma to the affected area, even seemingly minor injuries, can also predispose individuals to fat necrosis.

Radiation therapy, often used in the treatment of cancer, is another important consideration.

Documenting any history of these factors can provide valuable context and guide the diagnostic approach.

The Role of Medical Professionals in Diagnosis

A collaborative approach involving radiologists, surgeons, and pathologists is crucial for accurate diagnosis. Radiologists interpret imaging studies to identify and characterize suspicious lesions. Surgeons perform biopsies when necessary to obtain tissue samples for pathological examination. Pathologists analyze these samples to confirm the diagnosis and rule out malignancy.

Diagnostic Modalities: Imaging Techniques for Fat Necrosis

Fat necrosis is a benign condition characterized by the death of fat cells. This localized process typically results from injury or insufficient blood supply to fatty tissue. While it can occur in various parts of the body, it is most commonly observed in the breast and subcutaneous tissue. When evaluating potential cases of fat necrosis, the integration of various imaging techniques is essential to accurately distinguish this benign condition from malignant lesions.

This section offers a comprehensive review of the imaging modalities commonly employed in the diagnosis of fat necrosis, including ultrasound, mammography, and magnetic resonance imaging (MRI). Each technique is discussed in terms of its specific role, characteristic findings, and inherent limitations.

Ultrasound: A Primary Imaging Modality

Ultrasound is often the initial imaging modality of choice in evaluating palpable abnormalities and suspected cases of fat necrosis. Its accessibility, lack of ionizing radiation, and ability to characterize tissue composition make it an invaluable tool.

Characteristic Ultrasound Features of Fat Necrosis

The sonographic appearance of fat necrosis is variable and can range from completely anechoic (fluid-filled) cysts to complex, solid-appearing masses with shadowing.

Common features include:

• Hypoechoic or anechoic areas: Representing oil cysts or liquefied fat.
• Hyperechoic areas: Corresponding to fibrosis, inflammation, or calcifications.
• Posterior acoustic shadowing: Suggesting dense or calcified components.
• Circumscribed or irregular borders: The margins may be well-defined or ill-defined, adding to diagnostic complexity.

Optimizing Ultrasound Technique: High-Frequency Linear Array Transducers

To achieve optimal image resolution and detail, high-frequency linear array transducers are typically used. These transducers provide superior visualization of superficial structures, allowing for detailed assessment of the size, shape, and internal characteristics of the lesion.

Adjunctive Ultrasound Techniques: Color Doppler and Elastography

In addition to conventional B-mode ultrasound, adjunctive techniques such as color Doppler imaging and elastography can provide further diagnostic information.

• Color Doppler ultrasound: Assesses blood flow within and around the lesion. Fat necrosis typically demonstrates minimal or absent vascularity, helping to differentiate it from malignant lesions with increased blood flow.

• Elastography: Measures the stiffness or elasticity of tissues. Fat necrosis may exhibit varying degrees of stiffness depending on the stage of the lesion, with older lesions often showing increased stiffness due to fibrosis. Elastography can help to differentiate fat necrosis from more elastic, benign lesions and potentially from stiffer, malignant masses.

Mammography: Complementary Role and Diagnostic Challenges

Mammography is another important imaging modality in the evaluation of breast lesions. While it is not always definitive in diagnosing fat necrosis, it can provide valuable information and help guide further investigation.

Mammographic findings of fat necrosis can include:

• Oil cysts: Well-circumscribed, radiolucent lesions with a characteristic appearance.
• Coarse calcifications: Typically located in the periphery of the lesion.
• Architectural distortion: Resulting from fibrosis and scarring.
• Spiculated masses: Can mimic malignancy and require further evaluation.

One of the key challenges with mammography is differentiating fat necrosis from malignant lesions, particularly spiculated masses. The presence of suspicious features, such as irregular borders or increasing size, may warrant additional imaging or biopsy to rule out cancer.

It’s crucial to recognize the utility of mammography as a complementary, rather than definitive, diagnostic tool for fat necrosis. Its effectiveness is significantly enhanced when interpreted in conjunction with ultrasound findings. The combined use of these modalities facilitates a more comprehensive assessment and improves diagnostic accuracy.

Other Imaging Modalities: MRI

Magnetic resonance imaging (MRI) can be useful in certain cases, particularly when ultrasound and mammography findings are inconclusive or when evaluating the extent of disease.

MRI characteristics of fat necrosis include:

• Variable signal intensity: Depending on the stage of the lesion.
• Fat-containing areas: Demonstrating high signal intensity on T1-weighted images.
• Enhancement patterns: Variable, ranging from no enhancement to rim enhancement.

MRI can be particularly helpful in differentiating fat necrosis from recurrent cancer or other soft tissue masses. However, it is important to note that MRI findings can also overlap with those of malignant lesions, and biopsy may still be necessary for definitive diagnosis.

Therefore, the interpretation of MRI results should always be correlated with clinical and other imaging findings to ensure an accurate diagnosis.

Biopsy and Pathological Confirmation: Confirming the Diagnosis

Following clinical and radiological assessment, definitive diagnosis of fat necrosis often hinges on pathological confirmation via biopsy. This invasive yet crucial step allows for microscopic examination of the affected tissue, distinguishing fat necrosis from other entities, including malignancy. The selection of the appropriate biopsy technique and the subsequent pathological interpretation are pivotal in guiding clinical management.

The Role of Biopsy in Definitive Diagnosis

While imaging modalities such as ultrasound and mammography provide valuable insights, they often lack the specificity to definitively diagnose fat necrosis. Overlapping features with malignant lesions necessitate tissue sampling for accurate characterization. Biopsy, whether through core needle aspiration, excisional method or fine-needle, provides a tangible sample that can be analyzed at a cellular level. This is a crucial step towards preventing misdiagnosis and subsequent overtreatment.

Biopsy Techniques: Choosing the Right Approach

Several biopsy techniques are available, each with its advantages and limitations:

Fine Needle Aspiration (FNA)

FNA involves using a thin needle to aspirate cells from the suspicious area. While minimally invasive, FNA yields only a small sample, potentially limiting diagnostic accuracy.

Its primary role is often in differentiating cystic from solid lesions, though it may not always provide sufficient material for definitive diagnosis of fat necrosis.

Core Needle Biopsy

Core needle biopsy employs a larger needle to extract a core of tissue.

This technique provides a more substantial sample than FNA, allowing for better assessment of tissue architecture and cellular morphology. It is often favored as the initial biopsy method for suspected fat necrosis due to its balance of accuracy and minimal invasiveness.

Excisional Biopsy

Excisional biopsy involves surgically removing the entire lesion or a representative portion. This technique provides the largest sample and allows for complete evaluation of the affected tissue.

However, it is more invasive than FNA or core needle biopsy and is typically reserved for cases where other biopsy methods are inconclusive or when complete removal of the lesion is desired for symptomatic relief or diagnostic certainty.

Pathological Features of Fat Necrosis

Microscopic examination of biopsy samples reveals characteristic features of fat necrosis.

These include the presence of foamy histiocytes, multinucleated giant cells, and cystic spaces containing oily material. Calcifications are also frequently observed, particularly in older lesions.

The presence of these features, along with the absence of malignant cells, confirms the diagnosis of fat necrosis.

Foamy histiocytes, which are macrophages that have ingested lipid material, are a hallmark of fat necrosis. Their presence indicates the body's attempt to clear the necrotic debris.

The Pathologist's Role in Confirming the Diagnosis

The pathologist plays a critical role in interpreting biopsy samples and rendering a diagnosis of fat necrosis. Their expertise is essential in differentiating fat necrosis from other benign and malignant conditions.

The pathologist evaluates the cellular morphology, tissue architecture, and presence of specific markers to arrive at an accurate diagnosis.

A detailed pathological report, including a description of the microscopic findings and a definitive diagnosis, is crucial for guiding clinical decision-making. The pathologist will also ensure the tissue sample is prepared correctly for all analysis.

In summary, biopsy and pathological examination are indispensable for confirming the diagnosis of fat necrosis. The choice of biopsy technique, the recognition of characteristic pathological features, and the expertise of the pathologist are all critical components of this diagnostic process. This accurate diagnosis is paramount in ensuring appropriate management and preventing unnecessary interventions.

Differential Diagnosis: Distinguishing Fat Necrosis from Other Conditions

Following clinical and radiological assessment, definitive diagnosis of fat necrosis often hinges on pathological confirmation via biopsy. This invasive yet crucial step allows for microscopic examination of the affected tissue, distinguishing fat necrosis from other entities, including malignant tumors. The task is frequently complex, demanding a meticulous and integrative approach.

The Challenge of Differentiation

The clinical and radiological presentation of fat necrosis can mimic other conditions, most notably breast cancer, creating a diagnostic challenge. The overlapping features necessitate a comprehensive evaluation that considers the patient’s history, physical examination findings, and detailed analysis of imaging and pathological results. Failing to accurately differentiate can result in unnecessary anxiety, further invasive procedures, or delayed appropriate treatment for other conditions.

Importance of Clinical Context

The clinical context plays a pivotal role in narrowing the differential diagnosis. A history of trauma, previous surgery, or radiation therapy to the affected area significantly increases the likelihood of fat necrosis. The absence of such a history, however, does not exclude the possibility of fat necrosis. It warrants a higher degree of suspicion for other etiologies.

Decoding Imaging Findings

Imaging modalities, such as ultrasound and mammography, provide valuable insights. However, the appearance of fat necrosis on these scans can be highly variable.

Some features, like oil cysts, are relatively specific for fat necrosis.

However, other findings, such as irregular masses or architectural distortion, can overlap with malignant lesions. Therefore, relying solely on imaging is often insufficient for definitive diagnosis.

The Decisive Role of Pathological Evaluation

Pathological evaluation of biopsy specimens is often required to confirm a diagnosis of fat necrosis. Microscopic examination reveals characteristic features such as:

• Foamy histiocytes.
• Giant cells.
• Areas of fat saponification.
• Calcification.

However, even these features can be subtle or obscured by other inflammatory processes, making interpretation challenging.

Benign Lesions and Inflammatory Mimics

In addition to malignancy, other benign lesions and inflammatory conditions can mimic fat necrosis. These include:

• Fibrocystic changes: Common in the breast, these changes can cause lumpiness and tenderness, mimicking the presentation of fat necrosis.
• Granulomatous mastitis: This inflammatory condition can present with firm masses and skin changes, requiring careful differentiation.
• Abscesses: Localized collections of pus can also present as palpable masses, especially in the setting of infection.
• Scar tissue: Prior surgical interventions can lead to scar tissue formation which could be misinterpreted as fat necrosis.

A meticulous evaluation considering both imaging characteristics and patient history is paramount to determine the accurate diagnosis.

An Integrative Approach

Distinguishing fat necrosis from other conditions requires an integrative approach, incorporating clinical, radiological, and pathological findings. This often involves a multidisciplinary team, including:

• Radiologists
• Pathologists
• Surgeons
• Referring physicians

By carefully weighing all available evidence, clinicians can arrive at the most accurate diagnosis and guide appropriate management decisions. This ultimately minimizes patient anxiety and ensures optimal outcomes.

Role of Medical Professionals: Who's Involved in Your Care

Following clinical and radiological assessment, definitive diagnosis of fat necrosis often hinges on pathological confirmation via biopsy. This invasive yet crucial step allows for microscopic examination of the affected tissue, distinguishing fat necrosis from other entities. The diagnostic and management pathway necessitates a coordinated effort from various medical professionals, each contributing unique expertise.

The Radiologist: Imaging Interpretation Expert

Radiologists play a crucial role in the initial evaluation of suspected fat necrosis. Their expertise in interpreting various imaging modalities, such as ultrasound, mammography, and MRI, is paramount in identifying characteristic features suggestive of fat necrosis.

A radiologist’s report often guides subsequent steps, helping differentiate fat necrosis from potentially malignant lesions. They are vital in characterizing the size, shape, and location of the lesion.

Their insights help determine the need for further investigation, such as a biopsy.

The Sonographer: Ultrasound Examination Specialist

Sonographers, or ultrasound technicians, are the skilled professionals who perform the ultrasound examinations.

Their technique and attention to detail directly impact the quality and accuracy of the images obtained. They are responsible for optimizing imaging parameters and capturing images that accurately represent the underlying tissue structure.

Furthermore, their ability to recognize subtle changes and artifacts is crucial for identifying potential areas of concern. They will frequently collaborate with radiologists during the examination.

Referring Physicians: Initial Detection and Referral

Referring physicians, including primary care physicians (PCPs) and gynecologists, are often the first point of contact for patients experiencing symptoms.

Their role is to conduct initial clinical assessments and determine the need for further evaluation. They consider the patient's medical history, perform physical examinations, and order appropriate imaging studies.

Prompt recognition of suspicious findings and timely referral to specialists are vital for ensuring appropriate and timely management.

Surgeons: Biopsy and Excision Experts

Surgeons, encompassing general surgeons, breast surgeons, and plastic surgeons, are involved in performing biopsies and surgical excisions when indicated.

A biopsy provides a tissue sample for pathological examination, allowing for definitive diagnosis. Surgeons carefully select the biopsy method (core needle or excisional) based on the lesion's characteristics and location.

In cases where fat necrosis is symptomatic or diagnostically uncertain, surgical excision may be necessary. The surgeon's expertise ensures complete removal of the lesion while minimizing cosmetic impact.

The Oncologist: Consultation in Mimicking Malignancy

While fat necrosis is a benign condition, its presentation can sometimes mimic malignancy. In such cases, an oncologist may be consulted to provide additional expertise.

The oncologist can help assess the risk of malignancy and guide management decisions. Their input is particularly valuable when imaging findings are ambiguous or when there is a strong clinical suspicion of cancer.

Oncologists are integral to ensure that patients receive appropriate and tailored care.

A Collaborative Approach: The Key to Optimal Care

Effective management of fat necrosis requires a collaborative approach involving all these medical professionals.

Open communication and shared decision-making ensure that patients receive the most appropriate and timely care. Each member of the healthcare team brings unique skills and knowledge, contributing to accurate diagnosis and tailored management strategies.

This multidisciplinary approach minimizes unnecessary anxiety and intervention, ultimately improving patient outcomes.

Management and Follow-Up: Navigating Life After a Fat Necrosis Diagnosis

Following clinical and radiological assessment, definitive diagnosis of fat necrosis often hinges on pathological confirmation via biopsy. This invasive yet crucial step allows for microscopic examination of the affected tissue, distinguishing fat necrosis from other entities. The diagnostic journey culminates in a tailored management plan, designed to alleviate symptoms, allay anxieties, and ensure long-term well-being. What does this plan entail, and what can patients realistically expect after receiving a diagnosis of fat necrosis?

Conservative Management: The Watchful Waiting Approach

For the majority of individuals diagnosed with fat necrosis, particularly those presenting without significant symptoms, a conservative management approach is generally recommended. This translates to a strategy of watchful waiting, where active intervention is deferred in favor of diligent monitoring.

This approach is predicated on the typically benign and self-limiting nature of fat necrosis.

Regular clinical examinations, often coupled with periodic imaging studies like ultrasound, are scheduled to track any changes in the size, shape, or characteristics of the affected area.

The frequency of these follow-up appointments is usually dictated by individual circumstances and the initial diagnostic findings.

Importantly, this conservative pathway isn’t passive. It empowers both clinicians and patients to observe the natural progression of the condition, intervening only if necessary.

Surgical Excision: When Intervention Becomes Necessary

While conservative management proves sufficient in many cases, surgical excision remains a viable option when dealing with either symptomatic lesions or situations where diagnostic uncertainty persists. Symptomatic lesions may include painful, tender, or rapidly enlarging masses that significantly impact the patient's quality of life.

In such instances, surgical removal of the affected tissue becomes a therapeutic consideration.

Diagnostic Uncertainty: Bridging the Gaps in Knowledge

Surgical excision also plays a crucial role in situations where diagnostic ambiguity persists despite thorough clinical and radiological assessments. When imaging findings are equivocal or raise suspicion of malignancy, a biopsy, whether core needle or excisional, may be warranted.

If the biopsy results remain inconclusive or discordant with the clinical picture, a surgical excision provides a larger tissue sample for comprehensive pathological evaluation.

This definitive diagnostic procedure helps to rule out alternative diagnoses, particularly breast cancer, and ensures that appropriate treatment strategies are implemented.

The Surgical Procedure: What to Expect

The specific surgical technique employed varies depending on the size, location, and extent of the fat necrosis.

In some cases, a wide local excision may be necessary to completely remove the affected tissue along with a margin of surrounding healthy tissue. The decision regarding the optimal surgical approach is made collaboratively between the surgeon and the patient, taking into account individual factors and preferences.

Follow-Up Monitoring: Ensuring Long-Term Stability

Regardless of whether conservative or surgical management is pursued, regular follow-up remains paramount. Scheduled clinical examinations and imaging studies, such as ultrasound or mammography, allow clinicians to monitor the treated area for any signs of recurrence or the development of new lesions.

Moreover, follow-up visits provide an opportunity to address any patient concerns, answer questions, and reinforce the benign nature of the condition. The frequency and duration of follow-up are tailored to each individual, considering factors such as age, medical history, and initial diagnostic findings.

Counseling and Reassurance: Addressing Patient Anxiety

Given the potential for diagnostic confusion and the emotional distress that can accompany the discovery of a breast lump, counseling and reassurance play a pivotal role in the management of fat necrosis.

Healthcare professionals must prioritize open and honest communication with patients, thoroughly explaining the nature of the condition, the rationale behind the chosen management strategy, and the expected outcomes.

Emphasizing the benign nature of fat necrosis and addressing any fears or misconceptions can significantly alleviate patient anxiety and improve overall quality of life. By providing compassionate support and clear, concise information, clinicians can empower patients to navigate their diagnosis with confidence and peace of mind.

So, there you have it – a quick rundown on what fat necrosis on ultrasound looks like and what to expect. Remember, any changes you notice should always be checked out by your doctor, but hopefully this guide has helped ease some worries and given you a better understanding of the process.