LESSON 14
DIAGNOSTIC RADIOLOGY OF FEMALE REPRODUCTIVE SYSTEM
AND ASSOCIATED DISEASES
ULTRASOUND
US, both transabdominal and transvaginal, is a well-established method of
examining the female pelvis, uterus and ovaries. US remains the principal initial
imaging study in the work-up of gynaecologic disease. It is both safe and relatively
inexpensive. Currently, the potential role of US in gynaecologic imaging includes
lesion characterization of ovarian masses and identification of endometrial
abnormalities. For example,in endometritis mucous membrane of uterus becomes
rough, thicker and deformed.
Additionally, US is utilized to guide biopsy of pelvic tumours, though there is still
controversy surrounding the biopsy of sonographically indeterminate adnexal
masses. Favorable imaging for accurate diagnosis of uterine cancer is biopsy
under the supervision of ultrasound
A full bladder is important for transabdominal US to provide a sonic window.
Probes at 3.5–5.0 MHz are routinely employed. In comparison, the bladder should
be empty for transvaginal ultrasound. Higher frequency probes employed for
transvaginal US afford greater detail of the structures in the small pelvis due to
their closer apposition to the pelvic organs.
Ultrasound has many advantages in routine imaging: it is relatively inexpensive,
provides multiplanar views, is widely available and does not use ionizing radiation
or contrast media. However, it also has a number of limitations: it is operator-
dependent and image quality varies with patient body habitus and may be degraded
severely by patient bowel gas. Although endovaginal, sonohystero- and endorectal
US provide improved spatial resolution, and colour and Doppler studies may
provide additional information on vascularity.
DIAGNOSTIC RADIOLOGY OF FEMALE REPRODUCTIVE SYSTEM
AND ASSOCIATED DISEASES
ULTRASOUND
US, both transabdominal and transvaginal, is a well-established method of
examining the female pelvis, uterus and ovaries. US remains the principal initial
imaging study in the work-up of gynaecologic disease. It is both safe and relatively
inexpensive. Currently, the potential role of US in gynaecologic imaging includes
lesion characterization of ovarian masses and identification of endometrial
abnormalities. For example,in endometritis mucous membrane of uterus becomes
rough, thicker and deformed.
Additionally, US is utilized to guide biopsy of pelvic tumours, though there is still
controversy surrounding the biopsy of sonographically indeterminate adnexal
masses. Favorable imaging for accurate diagnosis of uterine cancer is biopsy
under the supervision of ultrasound
A full bladder is important for transabdominal US to provide a sonic window.
Probes at 3.5–5.0 MHz are routinely employed. In comparison, the bladder should
be empty for transvaginal ultrasound. Higher frequency probes employed for
transvaginal US afford greater detail of the structures in the small pelvis due to
their closer apposition to the pelvic organs.
Ultrasound has many advantages in routine imaging: it is relatively inexpensive,
provides multiplanar views, is widely available and does not use ionizing radiation
or contrast media. However, it also has a number of limitations: it is operator-
dependent and image quality varies with patient body habitus and may be degraded
severely by patient bowel gas. Although endovaginal, sonohystero- and endorectal
US provide improved spatial resolution, and colour and Doppler studies may
provide additional information on vascularity.
