Gynecology_Ultrasound_Presentation n.pptx

Gynecology

1. Introduction Gynecological ultrasound is a non-invasive imaging technique for evaluating female reproductive organs. Used for diagnosis, monitoring, and guiding procedures. Can be performed transabdominally or transvaginally.

2. Indications Pelvic pain Abnormal uterine bleeding Infertility evaluation Ovarian cysts and masses Early pregnancy assessment Monitoring treatment response

3. Types of Ultrasound Transabdominal Ultrasound (TAUS): - Requires full bladder - Wide field of view Transvaginal Ultrasound (TVUS): - High-resolution imaging of uterus and ovaries - Useful in early pregnancy and pelvic pathology

4. Anatomy on Ultrasound Uterus: Endometrium, myometrium, fundus, cervix Ovaries: Size, follicles, corpus luteum Adnexa: Fallopian tubes (usually not visualized unless pathological) Bladder: Important for TAUS

5. Normal Uterine Findings Shape: Pear-shaped Size: Pre-menopausal 7-8 cm × 4-5 cm × 3-4 cm Endometrium: Thickness varies with menstrual cycle Myometrium: Homogeneous echotexture

6. Normal Ovarian Findings Size: 3 cm × 2 cm × 1.5 cm (average) Follicles: Multiple small anechoic structures Corpus luteum: Variable echogenicity, often with peripheral flow on Doppler

7. Common Pathologies Uterine: Fibroids, adenomyosis, endometrial polyps Ovarian: Cysts, PCOS, tumors Adnexal masses: Ectopic pregnancy, tubo-ovarian abscess Endometrial abnormalities: Hyperplasia, carcinoma

8. Ultrasound Features of Fibroids Well-defined hypoechoic masses Distortion of endometrial contour Variable vascularity on Doppler Types: Intramural, submucosal, subserosal

9. Ultrasound Features of Ovarian Cysts Simple cysts: Anechoic, thin-walled, posterior acoustic enhancement Complex cysts: Internal echoes, septations, solid components PCOS: Multiple small peripheral follicles, increased stromal echogenicity

10. Endometrial Assessment Thickness varies by menstrual phase - Early proliferative: 4–6 mm - Secretory: 8–14 mm Endometrial polyps: Focal thickening, cystic spaces Hyperplasia or carcinoma: Thickened, heterogeneous, increased vascularity

11. Doppler Ultrasound in Gynecology Evaluates vascularity of lesions Helps differentiate benign vs malignant Common indices: Resistive Index (RI), Pulsatility Index (PI)

12. Early Pregnancy Evaluation Confirm intrauterine pregnancy Assess gestational sac, yolk sac, fetal pole Evaluate viability (cardiac activity) Detect ectopic pregnancy

13. Ultrasound in Infertility Follicular tracking during ovulation Assess uterine anomalies Detect ovarian reserve (antral follicle count) Guide assisted reproductive procedures

14. Limitations Operator dependent Limited visualization in obese patients (for TAUS) Difficulty in distinguishing complex adnexal masses Cannot evaluate deep pelvic structures as well as MRI

15. Summary Gynecological ultrasound is first-line, non-invasive, cost-effective Transvaginal approach provides high-resolution images Key for diagnosis, monitoring, and management of female reproductive disorders Complemented by Doppler and 3D imaging in complex cases

16. References Rumack CM, et al. Diagnostic Ultrasound, 6th Edition Fleischer AC, et al. Gynecologic Ultrasound: Principles and Practice ACR Practice Parameter for the Performance of Ultrasound of the Female Pelvis