Gynecology Book

Breast Disorders

Pelvis

  • Transvaginal Ultrasound

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Transvaginal UltrasoundAka: Endovaginal ultrasonography

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  1. Indications
    1. Fetal Ultrasound or Ectopic Pregnancy evaluation
      1. Early first trimester (before day 42, HCG <6000)
    2. Postmenopausal uterine bleeding
    3. Pelvic mass
    4. Dysmenorrhea
    5. Infertility evaluation
  2. Technique
    1. Uterus
      1. Check cervix with the probe pulled slightly back
      2. Measure Uterine Size in sagittal and coronal views
      3. Identify posterior masses and cul-de-sac fluid
    2. Ovaries
      1. Ovaries are adjacent to the femoral vessels
      2. Identify free fluid near adnexa
      3. Completely scan ovaries in two planes
      4. Normal ovarian volume: 6-14 cubic cm
    3. Endometrium
      1. Follicular Phase: Endometrium begins to thicken
      2. Ovulation: Triple line seen
      3. Secretory phase: Endometrium echogenic and 8-12 mm
      4. Postmenopausal: Thickness <6-8 mm
  3. Efficacy
    1. Postmenopausal Bleeding: Endometrial stripe evaluation
      1. Endometrial Stripe >5 mm considered abnormal
        1. Consider Endometrial Biopsy
      2. Scandinavian Study (n=1168 all with uterine bleeding)
        1. 114 women with Endometrial Cancer by biopsy
        2. No cancer cases in endometrial thickness <4mm
        3. Reference
          1. Karlsson (1995) Am J Obstet Gynecol 172:1488
      3. Japanese study (n=150, 47 with uterine bleeding)
        1. Six patients had Endometrial Cancer
        2. Three cancer patients had 2-4 cm thick endometrium
        3. Reference
          1. Tsuda (1995) Am J Obstet Gynecol 172:1494

Transvaginal echography (C0203418)

Definition (NCI)A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An instrument is inserted into the vagina, and sound waves bounce off organs inside the pelvic area. These sound waves create echoes, which a computer uses to create a picture called a sonogram.
Definition (NCI)A technique in which sound waves are sent out by an ultrasound probe that has been inserted in the vagina and a computer uses the ultrasound echoes to create an image of the female genital tract. The test can be performed to evaluate women with infertility problems, abnormal bleeding, sources of unexplained pain, congenital malformations of the uterus and ovaries, and possible tumors and infection.
ConceptsDiagnostic Procedure (T060)
EnglishTransvaginal echography, Transvaginal Ultrasound, Transvaginal ultrasound scan, TVS
Spanishecografia transvaginal
Parent ConceptsUltrasonography (C0041618), Infertility US scan (C0412554), Procedure by vaginal approach (C1298784), Ultrasound procedure on female genital system AND/OR pregnancy related structure (C0203416)
SourcesNCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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