Normal Ultrasound Female Pelvic Anatomy
Ultrasound imaging has shown an extremely rapid evolution in the last two decades, thanks to the development of highly sophisticated both two-dimensional (2D) and three-dimensional (3D) technology and blood flow mapping, which render ultrasound the first-
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Normal Ultrasound Female Pelvic Anatomy Vincenzo D’Addario, Asim Kurjak, and Biserka Funduk-Kurjak
Contents 3.1 Examination Techniques
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3.2 Uterus 3.2.1 Shape, Orientation, and Size 3.2.2 Myometrium 3.2.3 Endometrium 3.2.4 Uterine Perfusion
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3.3 Ovaries 3.3.1 Position, Shape, and Size 3.3.2 Changes During the Ovarian Cycle 3.3.3 Fallopian Tubes
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References
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Ultrasound imaging has shown an extremely rapid evolution 3.1 Examination Techniques in the last two decades, thanks to the development of highly sophisticated both two-dimensional (2D) and three- The ultrasound examination of the pelvis may be performed dimensional (3D) technology and blood flow mapping, either with a transabdominal transducer or with a transvagiwhich render ultrasound the first-line imaging modality for nal high resolution transducer. The transvaginal approach is the evaluation of the female pelvis. the best way of pelvic imaging since it offers the advantage The interpretation of the ultrasonographic findings of placing a high-frequency endocavitary ultrasound transrequires knowledge of the uterine and ovarian ultrasound ducer in close proximity to target pelvic organs, thus anatomy. improving image resolution and obviating the need for patients to have a full bladder before ultrasound examination (Figs. 3.1 and 3.2). It has the additional advantage of probing pelvic organs to elicit patient’s symptoms and thus correlating symptoms V. D’Addario (*) Department of Obstetrics and Gynecology, Medical School with specific pelvic anatomic locations. The practitioner University of Bari, Bari, Italy therefore can gain crucial information by adding ultrasound A. Kurjak findings with the physical examination [1]. Department of Obstetrics and Gynecology, Medical School 3D technology offers additional advantages to the evalUniversity of Zagreb, Zagreb, Croatia uation of the pelvic organs, such as multiplanar view, International Academy of Perinatal Medicine, Zagreb, Croatia tomographic view, rendering view, and volume calculaIan Donald Interuniversity School of Ultrasound in Medicine, tion [2, 3]. Zagreb, Croatia A further advantage is offered by the use of Color and B. Funduk-Kurjak Power Doppler technology which allows the examination of Department of Obstetrics and Gynecology, Medical School the vascular supply of the uterus and ovaries [4]. University of Zagreb, Zagreb, Croatia
© Springer Nature Switzerland AG 2020 A. Malvasi, D. Baldini (eds.), Pick Up and Oocyte Management, https://doi.org/10.1007/978-3-030-28741-2_3
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Fig. 3.1 Midsagittal plane of the pelvis
Fig. 3.2 Transvaginal ultrasound scans for the evaluation of the pelvis
3.2
On a sagittal plane, the uterus has a pyriform shape: the superior two thirds correspond to the uterine body and the inferior third to the cervix. The uterine isthmus is identified where the uterine body and cervix meet. The uterus may lie in the antiverted position (bent forward in relation to the
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