Gynecologic ultrasonography or gynecologic sonography refers to the application of
medical ultrasonography to the female pelvic organs (specifically the
uterus, the
ovaries, and the
fallopian tubes) as well as the
bladder, the
adnexa, and the
recto-uterine pouch. The procedure may lead to other medically relevant findings in the pelvis.This technique is useful to detect myomas or mullerian malformations.
Routes
The examination can be performed by
transabdominal ultrasonography, generally with a full bladder which acts as an
acoustic window to achieve better visualization of pelvis organs, or by
transvaginal ultrasonography with a specifically designed vaginal transducer. Transvaginal imaging utilizes a higher frequency imaging, which gives better resolution of the ovaries, uterus and
endometrium (the fallopian tubes are generally not seen unless distended), but is limited to depth of image penetration, whereas larger lesions reaching into the abdomen are better seen transabdominally. Having a full bladder for the transabdominal portion of the exam is helpful because sound travels through fluid with less attenuation to better visualize the uterus and ovaries which lies posteriorly to the bladder. The procedure is by definition
invasive when performed transvaginally. Scans are performed by health care professionals called sonographers, or gynecologists trained in ultrasound.
Through transvaginal sonography ovarian cysts can be aspirated. This technique is also used in
transvaginal oocyte retrieval to obtain human eggs (
oocytes) through sonographic directed transvaginal puncture of ovarian follicles in
IVF.
Gynecologic ultrasonography is sometimes
overused when it is used to screen for ovarian cancer in women who are not at risk for this cancer.[3] There is consensus that women with only average risk for ovarian cancer should not be screened with this procedure for cancer.[3]
Sonohysterography
Sonohysterography is a specialized procedure by which fluid, usually sterile saline (then called saline infusion sonography or SIS), is instilled into the uterine cavity, and gynecologic sonography performed at the same time. A review in 2015 came to the conclusion that SIS is highly
sensitive in the detection of intrauterine abnormalities in
subfertile women, comparable to
hysteroscopy. SIS is highly sensitive and
specific test in the diagnosis of
uterine polyps, submucous
uterine fibroids,
uterine anomalies and
intrauterine adhesions (as part of
Asherman's syndrome), and can be used as a screening tool for subfertile women prior to
IVF treatment.[4]