What this site offers  Go to IOTA course material

Click on the annotated images to open educational ultrasound volumes online. These volumes  can be scrolled through using a mouse or a touch-enabled device (smartphone).

Transabdominal gynecologic ultrasound imaging

The abdominal transducer is positioned in the midline cranial to the pubic bone. The landmarks to be included in the starting image should be the maximum sagittal diameter of the bladder and usually a median section of the uterus.

Retroflexed uterus

 

Retroflexed uterus with early pregancy

 

Handling the transvaginal transducer

First, the transducer is inserted carefully and gently into the introitus, making sure that no pressure is exerted in particular towards the anterior vaginal wall. At the level of the introitus the following structures can be seen (in case of an anteflexed uterus): (add VR)

With the transducer partially inserted, these structures can be seen: (add VR)

Having inserted the transducer in the axis of the vagina, placing its tip in the anterior fornix just in contact with the anterior uterine wall, provides the first view of an anteflexed uterus.

Turning the transducer to the right and slightly counterclockwise will display the external iliac vessels and often the right ovary.

Turning the transducer to the left and slightly clockwise will display the external iliac vessels and often the left ovary.

Turning and rotating the transducer further to the pelvic wall can display an oblique section of the uterus, the ovary laterally and, often, the Fallopian tube. (add VR ovary, tube and uterus)

 

This view benefits from the concurrent use of color Doppler as the vessels running alongside the tube can be used to identify it. (add VR)

Retroflexed uterus

 

Thick, hypoexchoic myometrium

 

Thick hyperechoic („transformed“) endometrium

 

Normal variants

Multifollicular ovary, tube and uterus

 

Hemorrhagic ovarian cyst

 

Hemorrhagic ovarian cyst (with color Doppler)

 

Intramural fibroids

 

 

Next…