Escolar Documentos
Profissional Documentos
Cultura Documentos
Sonographic Technique
A. Transabdominal Sonogram: 1. Performed with a distended bladder 2. Transducer is 3.5 to 5.0 Mhz 3. Done in sagittal & transverse planes
B. Transvaginal Sonogram: 1. Performed with an empty bladder 2. Transducer is 5.0 to 7.5 Mhz 3. Done in sagittal & coronal planes
ADVANTAGES OF TVS
Higher frequency = better resolution possible without filling bladder in obese patients in evaluating retroverted uterus better distinction of adnexae & bowels greater detail of internal characteristics of pelvic masses
Locate the uterus Examine the endometrium Visualize the cervix Image the adnexae Examine the posterior cul-de-sac
SONOGRAPHIC ANATOMY
Lies in the true pelvis between the urinary bladder and rectosigmoid colon Variable uterine position: Flexion Version Size and Shape varies: 1. Infantile or Prepubertal: L = 2.0 - 3.3 cms AP=0.5 - 1.0 cms. Tubular or inverse pear shape
4. Multiparous: increase in size by more than 1 cm in each adult dimension 5. Postmenopausal: uterus atrophies, most rapid after 10 yr Over 65 y/o : L = 3.5 - 6.5 cms. AP= 1.2 - 1.8 cms.
NORMAL MYOMETRIUM
1. Inner layer
2. Intermediate layer 3. Outer layer
NORMAL ENDOMETRIUM
PREMENOPAUSAL ENDOMETRIUM
Menstrual Phase
Proliferative Phase Secretory Phase
MENSTRUAL PHASE
PROLIFERATIVE PHASE
SECRETORY PHASE
to arrested development of Mullerian ducts Failure of fusion of Mullerian ducts Failure of resorption of median septum
LEIOMYOMA CLASSIFICATION
1. Intramural : confined to the myometrium 2. Submucosal : projecting into the uterine cavity 3. Subserosal : projecting from the peritoneal surface
LEIOMYOMA CLASSIFICATION
LEIOMYOMA CLASSIFICATION
1. Intramural Myoma
LEIOMYOMA CLASSIFICATION
2. Submucous Myoma
LEIOMYOMA CLASSIFICATION
3. Subserous Myoma
LIPOLEIOMYOMA
LEIOMYOSARCOMA
ADENOMYOSIS
Postmenopausal endometrium Hydrometrocolpos & Hematometrocolpos Endometrial hyperplasia Endometrial hypertrophy Endometrial polyps Endometrial carcinoma Endometritis Endometrial Adhesions (Synechiae) Intrauterine Devices
Bleeding
No Bleeding
Bleeding
No Bleeding
Sequencial Hormones
Normal
Biopsy
Biopsy
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