Gynecologic ultrasonography

Background
Gynecologic ultrasonography or Gynecologic sonography refers to the application of medical sonography to the female pelvic organs, specifically the uterus, the ovaries, the Fallopian tubes, as well as the bladder,the adnexa, the Pouch of Douglas, and any findings in the pelvis of relevance outside of pregnancy.

The examination can be performed transabdominally, generally with a full bladder which acts as an acoustic window to achieve better visualization of pelvis organs, or transvaginally 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 regarded as not painful, noninvasive, and relatively safe as no radiation is used. Scans are performed by health care professionals call sonographers, or gynecologists trained in ultrasound.

Gynecologic sonography is used extensively:
 * to assess pelvic organs,
 * to diagnose and manage gynecologic problems including endometriosis,leiomyoma, adenomyosis, ovarian cysts and lesions,
 * to identify adnexal masses, including ectopic pregnancy,
 * to diagnose gynecologic cancer
 * in infertility treatments to track the response of ovarian follicles to fertility medication (i.e. Pergonal).

Through transvaginal sonography ovarian cysts can be aspirated. This technique is used to obtain human eggs (oocytes) through sonographic directed transvaginal puncture of ovarian follicles in IVF.

Sonohysterography is a specialiced procedure by which fluid, usually sterile saline, is installed into the uterine cavity, and gynecologic sonography performed at the same time. The procedure delineates intrauterine pathology such as polyps, Asherman's syndrome, or submucous leiomyoma.