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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5824_Библиотеки_им_академика_М_И_Перельмана.pdf
Acknowledgments
Today one cannot imagine the practice of reproductive medicine without
imaging. Over the last 20 years in practice, we have seen so many advances
and improvements in ultrasound. See better, do ART better.
Special thanks to all of our mentors over the years, who trained us in the
areas of ultrasound, and thanks to our patients whom we learn from daily.
Norfolk, VA, USA Laurel A. Stadtmauer, MD, PhD
Chicago, IL, USA Ilan Tur-Kaspa, MD
xi
Contents
Part I Ultrasound Technique
1 Ultrasound in Reproductive Medicine: Is It Safe? . . . . . . . . . . 3
Jacques S. Abramowicz
2 Principles of 3D Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Maximilian Murtinger, Dietmar Spitzer,
and Nicolas Herbert Zech
3 Two-Dimensional and Three- Dimensional Doppler
in Reproductive Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Ernest Hung Yu Ng
4 Legal Aspects of Ultrasound Imaging
in Reproductive Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
James M. Shwayder
Part II Ultrasound in Infertility Workup
5 The Normal Ovary (Changes in the Menstrual Cycle). . . . . . . 49
Renato Bauman and Ursula Reš Muravec
6 Ovarian Reserve and Ovarian Cysts . . . . . . . . . . . . . . . . . . . . . 63
Laurel A. Stadtmauer, Alessandra Kovac,
and Ilan Tur-Kaspa
7 Ultrasound and PCOS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Nikolaos Prapas and Artemis Karkanaki
8 The Normal Uterus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Khaled Sakhel and Alfred Z. Abuhamad
9 Congenital Uterine Anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Beth W. Rackow
10 Uterine Fibroids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Bradley S. Hurst
11 Endometrial Polyps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Silvina M. Bocca
xiii
xiv
12 Intrauterine Adhesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Gautam N. Allahbadia
13 Sonohysterography in Reproductive Medicine . . . . . . . . . . . . . 167
Ilan Tur-Kaspa and Laurel A. Stadtmauer
14 Evaluation of Tubal Patency (HyCoSy, Doppler) . . . . . . . . . . . 179
Dimuthu Vinayagam and Kamal Ojha
15 Hydrosalpinx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Dale W. Stovall and Mark W. Austin
16 Virtual Hysterosalpingography:
A New Diagnostic Technique for the Study
of the Female Reproductive Tract . . . . . . . . . . . . . . . . . . . . . . . 199
Patricia Carrascosa and Carlos E. Sueldo
17 Ultrasound in Male Infertility. . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Landon W. Trost, David D. Casalino,
and Robert E. Brannigan
Part III Ultrasound in Infertility Treatment
18 Ultrasound in Follicle Monitoring
for Ovulation Induction/IUI . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Josef Blankstein, Shumal Malepati, and Joel Brasch
Contents
19 2D Ultrasound in Follicle Monitoring for ART . . . . . . . . . . . . . 251
Mette Toftager and David P. Cohen
20 3D Ultrasound for Follicle Monitoring in ART . . . . . . . . . . . . . 263
Maximilian Murtinger and Nicolas Herbert Zech
21 Ultrasound-Guided Surgical Procedures. . . . . . . . . . . . . . . . . . 283
Donna R. Session and Jennifer F. Kawwass
22 Ultrasound Role in Embryo Transfers . . . . . . . . . . . . . . . . . . . . 295
Edmond Confi no, Roohi Jeelani, and Ilan Tur-Kaspa
23 Ultrasound and Ovarian Hyperstimulation Syndrome . . . . . . 303
Laura Proud Smith
24 Pregnancy of Unknown Viability . . . . . . . . . . . . . . . . . . . . . . . . 315
Emily N.B. Myer, Jane Arrington, and Steven L. Warsof
25 Ultrasound Evaluation of Ectopic Pregnancy . . . . . . . . . . . . . . 329
Donald L. Fylstra
26 Focused Ultrasound for Treatment of Fibroids. . . . . . . . . . . . . 341
Gloria Richard-Davis and Elosha Eiland
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Contributors
Jacques S. Abramowicz , MD, FACOG, FAIUM Division of Maternal
Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State
University, Hutzel Women’s Hospital , Detroit , MI , USA
Alfred Z. Abuhamad , MD Department of Obstetrics and Gynecology,
Eastern Virginia Medical School, Norfolk , VA, USA
Gautam N. Allahbadia , MD, DNB, FNAMS Rotunda-The Center for
Human Reproduction , Mumbai , Maharashtra , India
Jane Arrington , RDMS Maternal Fetal Medicine , Eastern Virginia
Medical School , Virginia Beach , VA , USA
Mark W. Austin , MD Department of Obstetrics and Gynecology ,
Riverside Regional Medical Center , Newport News , VA , USA
Renato Bauman , MD, PhD Department of Gynecology and Obstetrics ,
Sveti Duh Clinical Hospital , Zagreb , Croatia, Europe
Josef Blankstein , MD, ARDMS Department of Obstetrics and
Gynecology , Rosalind Franklin University of Medicine and Science,
Mount Sinai Hospital , Chicago , IL , USA
Silvina M. Bocca , MD, PhD Department of Obstetrics and Gynecology ,
The Jones Institute for Reproductive Medicine , Norfolk , VA , USA
Robert E. Brannigan , MD Department of Urology , Northwestern
University, Feinberg School of Medicine , Chicago , IL , USA
Joel Brasch , MD Department of Obstetrics and Gynecology ,
Rosalind Franklin University of Medicine and Science,
The Chicago Medical School , Chicago , IL , USA
Patricia Carrascosa , MD Maipu Diagnostics , Buenos Aires , Argentina
David D. Casalino , MD Department of Radiology , Northwestern
University, Feinberg School of Medicine , Chicago , IL , USA
David P. Cohen , MD Department of Obstetrics and Gynecology/Section
of Reproductive Endocrinology , University of Chicago Medical Center ,
Chicago , IL , USA
xv
xvi
Edmond Confi no , MD Repro/Endo, Infertility , Feinberg School
of Medicine, Northwestern University , Chicago , IL , USA
Elosha Eiland , MD Department of Obstetrics and Gynecology ,
Meharry Medical College , Nashville , TN , USA
Donald L. Fylstra , MD Department of OBGYN , Medical University
of South Carolina , Charleston , SC , USA
Bradley S. Hurst , MD Department of Obstetrics and Gynecology ,
Carolinas Healthcare System , Charlotte , NC , USA
Roohi Jeelani , MD Department of Obstetrics and Gynecology ,
Wayne State University , Detroit , MI , USA
Artemis Karkanaki , MD, MSc, PhD Third Department of Obstetrics
and Gynecology , Hippokration General Hospital of Thessaloniki, Greece,
Aristotle University of Thessaloniki , Thessaloniki , Greece
Jennifer F. Kawwass , MD Division of Reproductive Endocrinology
and Infertility, Department of Gynecology and Obstetrics, Emory University
School of Medicine , Atlanta , GA , USA
Alessandra Kovac College of Arts and Sciences , University of Virginia ,
Charlottesville , VA , USA
Contributors
Shumal Malepati , MD Department of Obstetrics and Gynecology ,
Mount Sinai Hospital , Chicago , IL , USA
Ursula Reš Muravec , MD, MSc Department for infertility , Medical Center
Dravlje , Ljubljana , Slovenia, Europe
Maximilian Murtinger , MD IVF Centers Prof. Zech , Bregenz , Austria
Emily N. B. Myer , MD Department of Obstetrics and Gynecology ,
Eastern Virginia Medical School , Norfolk , VA , USA
Ernest Hung Yu Ng , MD, FRCOG (UK) Department of Obstetrics
and Gynaecology , The University of Hong Kong, Queen Mary Hospital ,
Pokfulam, Hong Kong , Hong Kong
Kamal Ojha , MRCOG Obstetrics and Gynecology , St. George’s Hospital,
London , Tooting, London , UK
Nikolaos Prapas , MD, MSc, PhD Third Department of Obstetrics
and Gynecology , Hippokration General Hospital of Thessaloniki,
Greece, Aristotle University of Thessaloniki , Thessaloniki , Greece
Beth W. Rackow , MD Department of Obstetrics and Gynecology ,
Columbia University Medical Center, Center for Women’s Reproductive
Care , New York , NY , USA
Gloria Richard-Davis , MD, FACOG Department of Obstetrics
and Gynecology , Meharry Medical College , Nashville , TN , USA
Contributors
xvii
Khaled Sakhel , MD, FACOG, FACS Division of Minimally Invasive
and Robotic Surgery , Eastern Virginia Medical School , Norfolk , VA , USA
Donna R. Session , MD Division of Reproductive Endocrinology and
Infertility, Department of Gynecology and Obstetrics , Emory University
School of Medicine , Atlanta , GA , USA
James M. Shwayder , MD, JD Department of Obstetrics and Gynecology ,
University of Mississippi , Jackson , MS , USA
Laura Proud Smith , MD Department of Reproductive Endocrinology and
Infertility, Reproductive Medicine and Surgery Center of Virginia, P.L.C ,
Charlottesville , VA , USA
Dietmar Spitzer , MD IVF Centers Prof. Zech , Salzburg , Austria
Laurel A. Stadtmauer , MD, PhD Department of Obstetrics
and Gynecology , Eastern Virginia Medical School, Jones Institute
for Reproductive Medicine , Norfolk , VA , USA
Dale W. Stovall , MD Department of Obstetrics and Gynecology ,
Riverside Regional Medical Center , Newport News , VA , USA
Carlos E. Sueldo , MD Department of Obstetrics and Gynecology
(Rei Division) , University of California San Francisco-Fresno , Clovis ,
CA , USA
Mette Toftager , MD, PhD Student Department of Gynecology
and Obstetrics, Section of Infertility , Hvidovre University Hospital ,
Hvidovre , Denmark
Landon W. Trost , MD Department of Urology , Mayo Clinic , Rochester ,
MN , USA
Ilan Tur-Kaspa , MD Institute for Human Reproduction (IHR) ,
Chicago , IL , USA
Department of Obstetrics and Gynecology , The University of Chicago ,
Chicago , IL , USA
Dimuthu Vinayagam , MB BS, BSc Obstetrics and Gynecology ,
St. George’s Hospital, London , Tooting, London , UK
Steven L. Warsof , MD Department of Obstetrics and Gynecology ,
Eastern Virginia Medical School , Norfolk , VA , USA
Nicolas Herbert Zech , MD Department of Obstetrics and Gynecology,
Medical University Graz , Bregenz , Austria
Part I
Ultrasound Technique
Ultrasound in Reproductive Medicine: Is It Safe?
Jacques S. Abramowicz
1
Introduction
The fi rst published description of the clinical use
of ultrasound in obstetrics and gynecology (ob/
gyn) dates from 1958 [ 1 ] and describes the value
of this new technology for the diagnosis of
abdominal masses, specifi cally, ovarian cysts.
Since then its use has increased exponentially
and is ubiquitous in the daily practice of ob/gyn.
Another fi eld that has equally burgeoned is reproductive endocrinology and infertility. These two
disciplines are strongly interconnected, in part
because of the major progresses made in image
quality and the introduction of new modalities,
such as color and spectral Doppler or threedimensional (3D) ultrasound, which has greatly
facilitated diagnosis, interventions, and certain
forms of therapy in fertility treatments and
assisted reproductive technology. Because ultrasound is a waveform, with alternating positive
and negative pressure, it has effects in tissues it
traverses. These may be thermal and nonthermal
(or mechanical). The question that bears asking
is: can these effects be detrimental to the developing follicle, ovum, or early fetus? A publication describing premature ovulation in women
J. S. Abramowicz , MD, FACOG, FAIUM
Division of Maternal Fetal Medicine,
Department of Obstetrics and Gynecology ,
Wayne State University, Hutzel Women’s Hospital ,
3990 John R Street , Detroit , MI 48201 , USA
e-mail: jabramow@med.wayne.edu
whose ovaries were exposed to ultrasound is
often quoted but dates from 1982 [ 2 ]. This chap-
ter will briefl y describe the physics of ultrasound
and its interaction with live tissue, defi ne bioeffects and on-screen indicators of potential risk,
focus on ovarian scanning in ART, and discuss
fetus susceptibility and safety measures.
Bioeffects and safety of ultrasound in pregnancy,
in general, and in later gestation, in particular,
will not be addressed. The interested reader may
consult various reviews on this topic [ 3 – 10 ]
A Short Review of Ultrasound Physics
Ultrasound is a waveform, characterized by various parameters: frequency is the number of cycles
per second, measured in Hertz (Hz). Human ears
can discern sounds at approximately 20–20,000 Hz.
Diagnostic ultrasound is, generally, 2–15 million
Hz (2–15 MHz). Wavelength is the distance
between two corresponding points on a particular
wave. It is inversely proportional to the frequency
(0.2–1.5 mm). Resolution (i.e., the shortest dis-
tance between two points which allows these two
points to be seen separately) depends on the wavelength: the axial resolution ranges between 2 and 4
wavelengths. Therefore, the smaller the wavelength (which corresponds to the higher the frequency), the better the resolution (the distance
between the two points is smaller) but the lower
the penetration. This explains why endovaginal
probes have better resolution (higher frequency)
L.A. Stadtmauer, I. Tur-Kaspa (eds.), Ultrasound Imaging in Reproductive Medicine,
DOI 10.1007/978-1-4614-9182-8_1, © Springer Science+Business Media New York 2014
3