1. Gynaecological Ultrasound Felipe Moretti, MD Griff Jones, MD, FRCS Assistant Professor – UOttawa Maternal Fetal Medicine Division

2. Basic physics Gynaecology

3. Ultrasound used for medical purposes is from one MHz (one million cycles per second) to 20 MHz.

4. Higher frequency wave assesses the object more often in any given time period. This results in more information and allows sharper images

5. If each wave represents a path, the walker uses the same energy to reach point X. Low frequency waves penetrate deeper into the tissues than high frequency waves

6. Summary Low frequency sound waves can penetrate more deeply but have less definition than high frequency waves The farther something is away from the probe, the worse the resolution

7. In OB GYN Ultrasound – – We use low frequency probes for abdominal scanning – We use high frequency probes for transvaginal scanning

8. Gyne Ultrasound Assess: Uterine pathologies (ex. Fibroids); Endometrial pathologies (ex.polyps); Ovarian pathologies (cysts)

9. Uterus

10. Uterine Position

11. Uterus Transvaginal

12. Uterine Fibroid

13. Uterine Enlargement

14. Difficult Fibroids

15. Endometrium changes Throughout the cycle

16. Anteverted uterus with follicular endometrium Retroverted uterus with secretory endometrium

17. Abnormal Endometrium

18. Cavity Enlargement

19. Ovaries

20. Trans-abdominal Ovarian Scan

21. Transvaginal Ovarian Scan

22. Depth of penetration was not an issue here. But the improved resolution due to the higher frequency of the TV probe shows ovarian substance and allows a diagnosis of polycystic ovaries Transabdominal Transvaginal

23. Normal Ovary

24. Ovarian appearance changes throughout the menstrual cycle

25. Cystic Follicle

26. Cyst Complications

27. resolved 2 weeks later

28. Ovarian Masses

30. Thank You