Posted on December 18, 2011
Although it is most frequently associated with antenatal scans, ultrasound, as a safe, non-invasive and widely available diagnostic tool, also plays an important role in gynaecological examinations outside of pregnancy. Particularly important is its ability to show soft tissue and differentiate between different tissue types. Common gynaecological ailments such as pelvic pain or vaginal bleeding are often investigated using ultrasonography in order to determine their cause, and it is also utilised in diagnosing causes of infertility as well as tracking the progress of infertility treatments. A gynaecologist can use ultrasonography to diagnose a number of conditions, such as ovarian cysts, fibroids and cancers.
Two types of examination are generally used by radiographers and sonographers working in gynaecology. The first is a transabdominal scan, a procedure similar to an antenatal pregnancy scan, which is often able to produce high quality images, especially of the bladder, cervix, uterus, ovaries and fallopian tubes. The patient lies face up on an examination table, and a gel is applied to the skin in order to improve the transmission of ultrasound waves from the transducer into the body. However, if this does not produce a sufficiently high resolution or detailed image of the reproductive organs, then a transvaginal scan can be employed to compliment the transabdominal results. This involves using a specially designed transducer that can be inserted into the vagina in order to get closer to the uterus and ovaries, requiring a less penetrating and higher resolution ultrasound frequency as the distance is reduced, producing much more detailed images of the pelvic organs. A transvaginal scan is most commonly employed when seeking to diagnose problems with the cervix and uterus, and is significantly less invasive and uncomfortable than a manual gynaecological examination. Most women report the procedure to be painless. However, the fallopian tubes do not normally show up on a transvaginal scan, and must be imaged transabdominally.
As ultrasound scanning works best when imaging tissues with a significant liquid content, an accurate ultrasonographical image of the inside of the uterus can be obtained by filling it with fluid. This is often used in conjunction with transvaginal scanning to diagnose uterine deformities and abnormalities, such as neoplasms, Asherman’s syndrome, endometrial atrophy and polyps. This procedure is referred to as sonohysterography, and is commonly employed by gynaecologists when diagnosing the causes of infertility. In order to achieve similar results when scanning the bladder, patients are requests to try to retain its contents.
The anxieties we had with our IVF pregnancy were allayed with the extra scans at Thornbury hospital with Tom Farrell.Helen (Sheffield)