The transvaginal approach gives clearer images with higher resolution than the transabdominal approach, because there is no tissue such as the abdominal wall causing distortion and reverberation of the ultrasonic waves between the probe and pelvic organs and because high frequency ultrasound can be used in the transvaginal approach. However improper usage of a transvaginal probe cannot give clear images and consequently leading to a inaccurate interpretation of the anatomy and misdiagnosis. Some techniques for obtaining clear images are described with a transvaginal images are described in other part.
Preparing the patient and the probe for transvaginal ultrasound
explain transvaginal sonography to the patient, especially when she has not undergone transvaginal sonography to ease her fearlet the patient urinate to vacate the bladder to bring the uterine body closer to the vaginal formix see the position and direction of the uterus and intrapelvic masses by vaginal examination or by transabdominal sonography before the transvaginal scanning. This preparation is important especially for beginners wipe the head of probe. Put a clean condom or a probe cover on the probe after putting ultrasonic jelly on the head or into the condom. Make sure that there is no bubble between the head and condom.
Probe insertion and rotation
wet the tip of the condom with clean water or put some cream on to insert the probe in to vagina smoothly without any pain to the patient insert the probe in to vagina slowly and obtain the sagittal longitudinal section of the uterus. It is landmark for gynecological examination. Come back to this nsection when the orientation is lost durting examination. If the vagina is too narrow for the transvaginal probe. Insert the probe into the rectum and scan pelvic organs through a rectal wall make sure that the direction of the image is always fixed not to lose or confuse the orientation. For example , the abdominal side of the image and the back side of the patient is displayed on the right side of the images as shown in figure. When the probe is rotated counter clock wise from 12 o’clock to 9 o’clock, a transverse section of the uterus parallel to the abdominal wall, is displayed on the left side f the image and the left side of the patient on the right side of the image. To kee[ the orientation correctly, it is important to rotate the probe always from 12 o clock to 9 o clock to go from sagittal section to transverse section of the uterus and 9 o’clock to 12 o’clock to go back sagittal section.
Preparing the patient and the probe for transvaginal ultrasound
explain transvaginal sonography to the patient, especially when she has not undergone transvaginal sonography to ease her fearlet the patient urinate to vacate the bladder to bring the uterine body closer to the vaginal formix see the position and direction of the uterus and intrapelvic masses by vaginal examination or by transabdominal sonography before the transvaginal scanning. This preparation is important especially for beginners wipe the head of probe. Put a clean condom or a probe cover on the probe after putting ultrasonic jelly on the head or into the condom. Make sure that there is no bubble between the head and condom.
Probe insertion and rotation
wet the tip of the condom with clean water or put some cream on to insert the probe in to vagina smoothly without any pain to the patient insert the probe in to vagina slowly and obtain the sagittal longitudinal section of the uterus. It is landmark for gynecological examination. Come back to this nsection when the orientation is lost durting examination. If the vagina is too narrow for the transvaginal probe. Insert the probe into the rectum and scan pelvic organs through a rectal wall make sure that the direction of the image is always fixed not to lose or confuse the orientation. For example , the abdominal side of the image and the back side of the patient is displayed on the right side of the images as shown in figure. When the probe is rotated counter clock wise from 12 o’clock to 9 o’clock, a transverse section of the uterus parallel to the abdominal wall, is displayed on the left side f the image and the left side of the patient on the right side of the image. To kee[ the orientation correctly, it is important to rotate the probe always from 12 o clock to 9 o clock to go from sagittal section to transverse section of the uterus and 9 o’clock to 12 o’clock to go back sagittal section.
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