Part 1:-When first scanning the
pelvis, many radiographers and radiologists suggest performing a transabdominal scan to first obtain an overview of the
pelvic organs, and second to assess the kidneys and renal tract if indicated.
Part 2: Subsequently, a transvaginal ultrasound examination of the pelvic organs is preferred to the
transabdominal approach as it not only
obviates the need for a full bladder with its associated discomfort but also allows high-frequency probes
(5-7.5 MHz) to be used so that higher resolution and greater precision
in measurements or measurements of the
pelvic structures, follicular diameters and endometrial thickness be
achieved
Adv of TVS?? It is
especially advantageous in patients who are
undergoing Gonadotrophin & IUI or assisted conception as they
commonly have lower abdominal scars
that impair the penetration of ultrasound; furthermore, periadnexal adhesions
may tether the ovaries deep in the pelvis and limit the elevation of these
structures that normally occurs when the
bladder is filled for a transabdominal scan.
What
does studies inform us?? A
study the follicles were more sharply defined
in 90% of cases when the transvaginal approach was used compared with only 41%
with a transabdominal approach.
The same study
found that the numbers and sizes of the dominant follicles correlated better with the serum oestradiol concentrations when
transvaginal scanning was used.
How useful is
estimation of ovarian volume in ultrasound assessment of ovarian volume and
AFC in the early follicular phase ? Ans .Such has been used as a predictor for ovarian response before IVF treatment,
with small-volume ovaries indicating reduced ovarian reserve.
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