Gynecologic Ultrasonography
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Gynecologic ultrasonography or gynecologic sonography refers to the application of
medical ultrasonography Medical ultrasound includes Medical diagnosis, diagnostic techniques (mainly medical imaging, imaging) using ultrasound, as well as therapeutic ultrasound, therapeutic applications of ultrasound. In diagnosis, it is used to create an image of ...
to the female pelvic organs (specifically the
uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...
, the
ovaries The ovary () is a gonad in the female reproductive system that produces ova; when released, an ovum travels through the fallopian tube/oviduct into the uterus. There is an ovary on the left and the right side of the body. The ovaries are endocr ...
, and the
fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (: salpinx), are paired tubular sex organs in the human female body that stretch from the ovaries to the uterus. The fallopian tubes are part of the female reproductive sy ...
) as well as the
bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...
, the adnexa, and the recto-uterine pouch. The procedure may lead to other medically relevant findings in the pelvis.This technique is useful to detect myomas or mullerian malformations.


Routes

The examination can be performed by transabdominal ultrasonography, generally with a full bladder which acts as an acoustic window to achieve better visualization of pelvis organs, or by transvaginal ultrasonography with a specifically designed vaginal transducer. Transvaginal imaging utilizes a higher frequency imaging, which gives better resolution of the ovaries, uterus and
endometrium The endometrium is the inner epithelium, epithelial layer, along with its mucous membrane, of the mammalian uterus. It has a basal layer and a functional layer: the basal layer contains stem cells which regenerate the functional layer. The funct ...
(the fallopian tubes are generally not seen unless distended), but is limited to depth of image penetration, whereas larger lesions reaching into the abdomen are better seen transabdominally. Having a full bladder for the transabdominal portion of the exam is helpful because sound travels through fluid with less attenuation to better visualize the uterus and ovaries which lies posteriorly to the bladder. The procedure is by definition invasive when performed transvaginally. Scans are performed by health care professionals called sonographers, or gynecologists trained in ultrasound.


Applications

Gynecologic sonography is used extensively: * to assess pelvic organs, * to diagnose
acute appendicitis Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications o ...
* to diagnose and manage gynecologic problems including
endometriosis Endometriosis is a disease in which Tissue (biology), tissue similar to the endometrium, the lining of the uterus, grows in other places in the body, outside the uterus. It occurs in women and a limited number of other female mammals. Endomet ...
, leiomyoma, adenomyosis, ovarian cysts and lesions, * to identify adnexal masses, including ectopic pregnancy, * to diagnose gynecologic cancer * in infertility treatments to track the response of
ovarian follicle An ovarian follicle is a roughly spheroid cellular aggregation set found in the ovaries. It secretes hormones that influence stages of the menstrual cycle. In humans, women have approximately 200,000 to 300,000 follicles at the time of puberty, ea ...
s to fertility medication (i.e. Pergonal). However, it often underestimates the true ovarian volume. Through transvaginal sonography ovarian cysts can be aspirated. This technique is also used in transvaginal oocyte retrieval to obtain human eggs (
oocyte An oocyte (, oöcyte, or ovocyte) is a female gametocyte or germ cell involved in reproduction. In other words, it is an immature ovum, or egg cell. An oocyte is produced in a female fetus in the ovary during female gametogenesis. The female ger ...
s) through sonographic directed transvaginal puncture of ovarian follicles in IVF. Gynecologic ultrasonography is sometimes overused when it is used to screen for ovarian cancer in women who are not at risk for this cancer., which cites * * * * There is consensus that women with only average risk for ovarian cancer should not be screened with this procedure for cancer.


Sonohysterography

Sonohysterography is a specialized procedure by which fluid, usually sterile saline (then called saline infusion sonography or SIS), is instilled into the uterine cavity, and gynecologic sonography performed at the same time. A review in 2015 came to the conclusion that SIS is highly sensitive in the detection of intrauterine abnormalities in subfertile women, comparable to hysteroscopy. SIS is highly sensitive and specific test in the diagnosis of uterine polyps, submucous uterine fibroids, uterine anomalies and intrauterine adhesions (as part of Asherman's syndrome), and can be used as a screening tool for subfertile women prior to IVF treatment.


See also

* Gynography * Gynoroentgenology *
Obstetric ultrasonography Obstetric ultrasonography, or prenatal ultrasound, is the use of medical ultrasonography in pregnancy, in which sound waves are used to create real-time visual images of the developing embryo or fetus in the uterus (womb). The procedure is a stand ...
* Sonosalpingography * Vaginal ultrasonography


References


External links


Information about Sonography

Fertility and Gynaecology Academy
{{DEFAULTSORT:Gynecologic Ultrasonography Diagnostic medical imaging Diagnostic obstetrics and gynaecology Female genital procedures Fertility medicine Medical ultrasonography