Transvaginal sonography and gynecologic imaging

Transvaginal sonography of the pelvis is useful to follow ovarian follicular maturation and to guide oocyte retrieval for in vitro fertilization. The author wish to broaden the indications for its use and to determine the advantages and drawbacks of this technique as compared to transvesical scanning. In 200 patients, transvesical and transvaginal pelvic US studies were compared for image quality, completeness of anatomic detail, and unique diagnostic information. Overall quality of image was better in 33% of transvaginal scans, 14% of transvesical scans, and equally good in 47%. Both techniques provided diagnostic information in 76% of cases. In only 14% of cases did the transvaginal probe allow a diagnosis to be rendered that could not have been made based on transvesical scanning alone. In 48% of cases, however, transvaginal scanning enhanced the examiner's diagnostic confidence. Individual organs and fine structures are better seen transvaginally, but the regional survey offered by the transvesical approach remains necessary to provide anatomic orientation. To augment sensitivity and specificity in pelvic sonography, the author suggest that transvaginal scanning be performed routinely along with transvesical scanning