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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5820_Библиотеки_им_академика_М_И_Перельмана.pdf
Image Protocol for the Transabdominal Sonographic Study of the Female Pelvis n 290
20. Same image as number 19 without calipers.
Labeled: LT OV TRV
(Courtesy University of Virginia Health Systems Imaging Center.)
SECTION TWO □ Image Protocol for the
Transvaginal Sonographic Study of the
Female Pelvis
PART IV
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 292
Criteria
In most cases, “trans” or “endo” vaginal sonography is used in conjunction with
transabdominal sonography when pelvic contents require further evaluation.
• Verbal or written consent is required from the patient. Explain the details of the
examination; inform the patient that the examination is virtually painless, that
the inserted transducer feels like a tampon, and that the examination is necessary
for the interpreting physician to make an accurate diagnosis.
• The examination should be chaperoned by a female health care professional. The
initials of the witness should be included as part of the film labeling.
• Begin studies with a survey of pelvic structures in at least 2 scanning planes.
• Do not share study results with the patient. Legally, only a physician can give a
diagnosis.
Transvaginal Female Pelvis Study
Uterus and Adnexa • Transvaginal Longitudinal Images
1. Longitudinal midline image. If the long axis of the uterus is visualized, then
include length and height measurements.
Labeled: TV SAG ML or TV SAG ML UT LONG AXIS (“TV” = transvaginal)
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 293
PART IV
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 294
2. Same image as number 1 without calipers.
Labeled: TV SAG ML or TV SAG ML UT LONG AXIS
SCANNING TIP: If the long axis was not visualized at the midline, it should be taken
here and label the image as follows:
TV SAG UT LONG AXIS
3. Longitudinal midline image with anteroposterior measurement of the endometrium.
SCANNING TIP: The measurement of the endometrium should include anterior and posterior
portions of the basal endometrium, the thickest
echogenic area, from 1 interface across the
endometrial canal to the other interface. The
adjacent hypoechoic myometrium and any
endometrial fluid should not be part of the
measurement.
Labeled: TV SAG ML ENDOM
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 295
PART IV
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 296
4. Same image as number 3 without calipers.
Labeled: TV SAG ML ENDOM
5. Longitudinal image of the uterus fundus to
include the endometrial cavity.
Labeled: TV SAG FUNDUS
6. Longitudinal image of the uterus body and
cervix to include the endometrial cavity.
Labeled: TV SAG BODY CERX
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 297
Uterus and Adnexa • Transvaginal
Axial Images
7. Axial image of the uterine fundus measuring
uterine width.
Labeled: TV COR FUNDUS
PART IV
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 298
8. Same image as number 7 without calipers.
Labeled: TV COR FUNDUS
9. Axial image of the uterine body.
Labeled: TV COR BODY
10. Axial image of the cervix.
Right Ovary • Transvaginal Axial Images
For the sake of instruction, this assumes that the
ovary long axis is visualized in a sagittal plane.
11. Axial image of the right ovary measuring
ovarian width.
Labeled: TV COR CERX
Labeled: TV COR RT OV
Image Protocol for the Transvaginal Sonographic Study of the Female Pelvis n 299
PART IV