Index

Donald School Textbook of Transvaginal Sonography Asim Kurjak, Jose Bajo Arenas

SECTION 1: GENERAL ASPECTS
CHAPTER 1:Transvaginal Probe: Technical Aspect
- Introduction
- Convex Probes
- Mechanical Sector Probes
- Three-dimensional Transvaginal Probes
- Accessories of a Transvaginal Probe
CHAPTER 2:Basis of Transvaginal Scanning
- Introduction
- Preparing the Patient and the Probe
- Probe Insertion and Rotation
- Basic Techniques in Transvaginal Scanning
- When a Clear Image Cannot be Obtained
CHAPTER 3:Ultrasound Safety in Transvaginal Scan
- Introduction
- Ultrasonic Bioeffect
- Ultrasound Safety in B-Mode
- Safety of Doppler Ultrasound (WFUMB Safety Statement on Doppler Ultrasound in Pregnancy)
- Safety of 3D Transvaginal Ultrasound
- Safety of 4D Transvaginal Ultrasound
- Nonmedical Use of Diagnostic Ultrasound
CHAPTER 4:Ultrasonic Tissue Characterization with Gray Level Histogram Width
- Introduction
- Methods
- Technical Results
- Clinical Results
CHAPTER 5:Transrectal Sonography
- Introduction
- Probes, Planes, and Orientation
- Indications of Transrectal Sonography
- Safety and Contraindications
- Technique and Preparation
- Authors’ Results
- Acknowledgment
SECTION 2: OBSTETRICS
CHAPTER 6:Fetal Anatomy on the First Trimester of Pregnancy
- Introduction
- Normal First Trimester Fetus
- Fetal Anatomy at 11–14 Weeks
- Studies Screening for Structural Defects by First Trimester Ultrasound
- Structural Defects at 11–14 Weeks
CHAPTER 7:Ultrasound Imaging of Early Extraembryonic Structures
- Introduction
- Gestational Sac
- Blighted Ovum
- Chorionic Plate
  - Subchorionic Hemorrhage
- Yolk Sac
CHAPTER 8:Ultrasound Markers of Aneuploidy in the First Trimester
- Introduction
- Nuchal Translucency
- Cystic Hygromas
- Fetal Growth Disorders
- Nasal Bone
- Megacystis
- Ductus Venosus Velocimetry
- Pulsatility Index of the Umbilical Artery
- Fetal Heart Rate
- Umbilical Cord
- Omphalocele
- Other Abnormalities
- Future Possibilities
CHAPTER 9:Early Detection of Fetal Abnormality
- Introduction
- Abnormal Yolk Sac
- Fetal Structural Anomaly
CHAPTER 10:Echocardiography in Early Pregnancy
- Introduction
- Technical Issues
- Ultrasound Anatomy of the Normal Heart
- Diagnosis of Congenital Heart Defects
- Advantages and Limitations
- Pathological Confirmation
- Indications of Early Fetal Echocardiography
CHAPTER 11:Assessment of Fetal Central Nervous System
- Introduction
- Transvaginal Approach to the Fetal Brain
- Three-dimensional Transvaginal Sonography
- Hydrocephalus and Ventriculomegaly
- Transvaginal Assessment of Congenital Central Nervous System Anomalies
CHAPTER 12:Ultrasonographic Signs of Poor Pregnancy Outcome
- Introduction
- Spontaneous Interruptions of the Development of the Conceptus, Frequency of the Spontaneous Abortion, Causes of the Abortion
- Normal Development in the First Trimester of Pregnancy
- Sonographic Findings to Diagnose an Interrupted Pregnancy
- Poor Prognosis of Pregnancy: Sonographic Findings
CHAPTER 13:Placenta and Transvaginal Sonography
- Safety and Accuracy of Trasvaginal Ultrasound
- Placenta Previa
- Placenta Accreta
CHAPTER 14:Assessment of Placental Vascularization by Three-dimensional Power Doppler Ultrasound: Placental Biopsy in Normal Pregnancies
- Introduction
- Three-dimensional Power Doppler “Placental Vascular Biopsy”
  - Validation of the “Placental Vascular Biopsy” Method
- Three-dimensional Doppler Indices During Normal Gestation
- Placental Biopsy in Fetal Growth
CHAPTER 15:Cervical Measurements and Preterm Labor
- Introduction
- Technique
- Interventions for Cervical Incompetence Based on Ultrasonographic Findings
CHAPTER 16:Transvaginal Assessment of the Cervix
- Introduction
- Measurement, Assessment, and the Pitfalls
- Prediction of the Preterm Delivery by Transvaginal Measurement of the Cervix
- Therapeutic Cervical Cerclage for Prevention of Preterm Delivery
- Transvaginal Cervical Length Measurement in Predicting Successful Labor Induction
CHAPTER 17:Cervix in the First Trimester of Pregnancy
- Introduction
- Cervical Length Measurement During the First Trimester of Pregnancy
- Cervicometry in the First Trimester: Newer Data
- Cervicometry in the First and Second Trimesters
CHAPTER 18:Transvaginal Sonography in Multiple Pregnancy
- Introduction
- Two-dimensional Sonography in Diagnosing Multiple Pregnancy
  - Most Common Pitfalls in Two-dimensional Diagnosis
    - Late Appearing Twin or “Undercounting”
    - Chorionicity and Amnionicity Determination During the Second Trimester
- Three-dimensional Sonography in Diagnosing Multiple Pregnancy
- Four-dimensional Sonography in Multiple Pregnancy
SECTION 3: GYNECOLOGY AND INFERTILITY
CHAPTER 19:Uterine Lesions
- Introduction
- Normal Uterus
- Endometrial Polyps
- Intrauterine Synechiae (Adhesions)
- Adenomyosis
- Endometrial Hyperplasia
- Endometrial Carcinoma
- Leiomyoma
- Leiomyosarcoma
CHAPTER 20:2D and 3D Power Doppler Ultrasound Study of Endometrium as Implantation Marker
- Introduction
- Two-dimensional Ultrasound and Doppler of the Endometrium
- Three-dimensional Ultrasound and Power Doppler of the Endometrium
  - Endometrial Volume
  - Three-dimensional Doppler Indices of Endometrial Perfusion
CHAPTER 21:Follicular Monitoring
- Introduction
- Follicular Assessment
- B Mode Features of a Mature Follicle
- Doppler Features of a Good Pre-hCG Follicle
- Implications of Flow Parameters on Ovum Quality
- Our Data
- Volume Ultrasound for Follicular Assessment
- Volume Ultrasound Parameters of Good Pre-hCG Follicle: Follicular Volume
- Cumulus
- 3D PD for Follicular Assessment
- 3D PD Indices and Follicular Quality
- Doppler Parameters of Follicle and Time of Intrauterine Insemination
- Endometrial Evaluation
- B Mode Features of Endometrium with Good Receptivity
- Doppler Features of Endometrium with Good Receptivity
- Uterine Artery Doppler
- Volume Ultrasound Assessment of Endometrium
- 3D and 3D PD Features of Good Endometrial Receptivity
- Contractions and Maximum Implantation Point
CHAPTER 22:Asymptomatic Simple Ovarian Cyst in Postmenopausal Women: Syndrome of “Visible Ovary”
- Introduction
- Natural History of the Postmenopausal Ovary
- Pathology of Simple Cysts
- Sonography
- Role of CA-125
- Management
CHAPTER 23:Transvaginal Sonography in Evaluation of Functional Ovarian Cysts
- Introduction
- Barcelona Experience
- Illustrative Examples
- Some Conclusions from Author's Experience
CHAPTER 24:Baseline Scan and Ultrasound Diagnosis of PCOS
- Introduction
- Baseline Scan
- Techniques for Baseline Scan of Ovaries
- Normal Ovaries
- Low Reserve Ovaries
- Poorly Responding Ovaries
- Polycystic Ovaries
- Antral Follicle Count
- Pathophysiology
- Antral Follicle Count in PCO and its Hormonal Implications
- Arrangement of Follicles
- Stromal Abundance
- Assessment of Stromal Abundance
- Stromal Abundance in PCO and its Hormonal Implications
- Stromal Vascularity
- Stromal Vascularity in PCO and its Hormonal Implications
- Deciding Stimulation Protocol
CHAPTER 25:Hormone Replacement Therapy: Ultrasound Role
- Introduction
- Physiology of Menopause and Postmenopausal Symptoms
- Hormone Replacement Therapy
- Ultrasound Role in “Pretreatment Assessment”
  - Transabdominal Ultrasound
  - Transvaginal Ultrasound
- Progesterone Challenge Test and Ultrasonography
- Color Doppler Ultrasound
- Sonohysterography
- Role of Ultrasound for “On Hormone Replacement Therapy Assessment”
- Effect of Hormone Replacement Therapy on Morphology of Uterus and Ovaries
  - Effect of Hormone Replacement Therapy on Endometrial Thickness
- Role of Ultrasound in Special Conditions
- Internal Carotid Artery and Cerebrovascular System
  - Effect of Hormone Replacement Therapy on Vascular Reactivity of Other Vessels
CHAPTER 26:Ectopic Pregnancy
- Introduction
- Role of Biochemical Markers in Ectopic Pregnancy
- Role of Ultrasound in the Diagnosis of Ectopic Pregnancy
- Other Sites of Implantation
- Therapy
CHAPTER 27:Female Pelvic Floor: Descriptive Anatomy and Clinical Exploration by Transvaginal Ultrasound Echography
- Introduction
- Echography Use in Pelvic Diagnosis
- Pathologies of the Posterior Pelvic Region
- Pathologies of the Anterior Pelvic Region
CHAPTER 28:Sonography of the Pelvic Infection
- Introduction
- Endometritis
- Hydrosalpinx
- Hysterosalpingosonography
- Sonographic Drainage as a Guide to Pelvic Abscess Perforation
CHAPTER 29:Sonohysterography
- Introduction
- Indications
- Technique
- Findings
- Complications
CHAPTER 30:Transvaginal Sonography in Postmenopausal Women
- Introduction
- Normal Endometrium in Menopause
- Postmenopausal Bleeding
- Endometrial Fluid Collections
- Myometrium in Menopause
- Normal Atrophic Ovary
- Ovary and Ovarian Cancer Screening
CHAPTER 31:Use of Different Ultrasound Techniques in the Field of Urogynecology
- Introduction
- Pelvic Organ Prolapse
- Pelvic Anatomy
SECTION 4: DOPPLER SONOGRAPHY
CHAPTER 32:Physical Principles of the Doppler Effect and its Application in Medicine
- Introduction
- Doppler Effect
- Doppler Indices
- Instrumentation for Doppler Measurements
- Data Acquisition
- Signal Processing
- Flow versus Velocity
- Two-dimensional Flow Measurement: Two-dimensional Color Doppler Display
- Power Doppler Ultrasound
- Basic Limitations of Doppler Examinations
  - Accuracy
  - Precision
- Contrast Media
- Artifacts
  - Aliasing
  - How to Reduce Problems?
- Acknowledgment
CHAPTER 33:Use of Ultrasound in the Field of Infertility
- Introduction
- Cyclic Changes
- Transvaginal Sonography of the Uterus and Ovaries During the Menstrual Cycle
- Transvaginal Color Doppler Assessment of Ovarian and Uterine Blood Flow
  - Ovarian Circulation
  - Uterine Circulation
- Uterine Perfusion in Infertile Patients
- Endometrial Thickness and Vascularity
- Three-dimensional and 3D Power Doppler Ultrasound Markers of Implantation
- Ovarian Causes of Infertility
- Uterine Causes of Infertility
- Tubal Causes of Infertility
CHAPTER 34:Chorionic Volume and Intervillous Blood Flow in Normal First Trimester Pregnancies Assessed by 3D Power Doppler Ultrasound
- Introduction
- Current Knowledge about Early Placental Circulation
- Intervillous Blood Flow and Chorionic Volume During the First Trimester Normal Pregnancies by 3D PDA
CHAPTER 35:Doppler Evaluation of the Ovary: Clinical Applications and Challenges
- Introduction
- Technique of Doppler Study
- Future Challenges
SECTION 5: 3D AND 4D TRANSVAGINAL SONOGRAPHY
CHAPTER 36:Three-dimensional Sonoembryology
- Introduction
- Three-dimensional Ultrasound Findings from Ovulation to Implantation
- Events Following Implantation
- Three-dimensional Ultrasound in Multiple Pregnancy
- Three-dimensional Ultrasound as a Tool for Measurement of the Nuchal Translucency
- Three-dimensional Ultrasound in Early Detection of Fetal Anomalies
- Dynamic Real-time 3D Ultrasound (4D Technique) as a Tool for Assessment of Fetal Behavior in Early Pregnancy
CHAPTER 37:Cesarean Scar Hysterotomy: Assessment by 3D Transvaginal Echography
- Background
- Echography Survey of Hysterotomy-Made Scars
- Material and Methods
- Results
CHAPTER 38:Assessment of Normal and Abnormal Ovaries by Transvaginal Sonography
- Introduction
- Sonographic Parameters
- Sonographic Differential Diagnosis of Pelvic Masses
- Evaluation of an Ovarian Mass
CHAPTER 39:Screening for Ovarian Cancer by Different Modes of Transvaginal Sonography
- Introduction
- Difficulties in Ovarian Cancer Screening
- Attempts to Screen— Some Lessons Learned
- Screening Tests
  - Serum Tumor Markers
  - Transvaginal Ultrasound
- Target Populations
  - General Population
    - Age and Menopausal Status
  - High-risk Population
    - Family History and/or Genetic Predisposition
- Ovarian Cancer Screening Trials
  - General Population
    - Ultrasound Screening
    - Multimodal Screening
  - High-risk Population
- Ovarian Cancer: The Role of 3D Ultrasound and 3D Power Doppler Imaging
  - What Does 3D Ultrasound Add?
  - Advantages of 3D Power Doppler Imaging
    - More Accurate Diagnosis of Ovarian Cancer
    - Detection of Stage I Disease
- Zagreb Ovarian Cancer Screening Trial
CHAPTER 40:Four-dimensional Technical Aspects
- Introduction
- Technicalities
CHAPTER 41:Fetal Upper Limb Movement in the First Half of Pregnancy Detected by Transvaginal 4D Ultrasound
- Introduction
- Ultrasound Approach to Fetal Movement
- Normal Fetal Hand and Finger Positioning and Movement in Early Pregnancy by 3D/4D Technology
- Abnormal Positioning and Contracture of Fetal Hand/Fingers
- Acknowledgments
CHAPTER 42:Advanced Sonographic Assessment of Benign Endometrial Disease
- Introduction
- Endometrial Hyperplasia
- Endometrial Polyps
- Endometrial Changes in Tamoxifen Patients

INDEX

TOC
Index

Chapter Notes