Gynaecological UltrasoundGynaecological Ultrasound

Felipe Moretti, MD

Griff Jones, MD, FRCS

Assistant Professor – UOttawa

Maternal Fetal Medicine Division

Basic physics

Gynaecology

Ultrasound used for medical purposes is from one MHz (one million cycles per second) to 20 MHz.

Higher frequency wave assesses the object more often in any given time period. This

results in more information and allows sharper images

If each wave represents a path, the walker uses the same energy to reach point X. Low frequency waves penetrate

deeper into the tissues than high frequency waves

SummarySummary

Low frequency sound waves can penetrate more deeply but have less definition than high frequency waves

The farther something is away from the probe, the worse the resolution

In OB GYN Ultrasound – – We use low frequency probes for abdominal

scanning– We use high frequency probes for transvaginal

scanning

Gyne UltrasoundGyne Ultrasound

Assess:

Uterine pathologies (ex. Fibroids);Endometrial pathologies (ex.polyps);Ovarian pathologies (cysts)

UterusUterus

Uterine PositionUterine Position

Uterus TransvaginalUterus Transvaginal

Uterine FibroidUterine Fibroid

Uterine EnlargementUterine Enlargement

Difficult FibroidsDifficult Fibroids

Endometrium changesThroughout the cycle

Anteverted uterus with follicular endometrium

Retroverted uterus with secretory endometrium

Abnormal EndometriumAbnormal Endometrium

Cavity EnlargementCavity Enlargement

OvariesOvaries

Trans-abdominal Ovarian ScanTrans-abdominal Ovarian Scan

Transvaginal Ovarian ScanTransvaginal Ovarian Scan

Depth of penetration was not an issue here. But the improved resolution due to the higher frequency of the TV probe shows ovarian substance and allows a

diagnosis of polycystic ovaries

Transabdominal Transvaginal

Normal OvaryNormal Ovary

Ovarian appearance changes throughout the menstrual cycle

Cystic FollicleCystic Follicle

Cyst ComplicationsCyst Complications

resolved 2 weeks laterresolved 2 weeks later

Ovarian MassesOvarian Masses

Thank YouThank You