Ultrasound in gynecology : an atlas and guide

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Foreword by Suresh Seshadri Foreword by Lil Valentin Preface Acknowledgements Contents List of Abbreviations About the Author 1: Introduction 2: General Techniques in Gynecological Ultrasound 2.1 Transabdominal Scan 2.2 Transvaginal Scan 2.3 Three-Dimensional Ultrasound (Figs. 2.10, 2.11, 2.12, 2.13, 2.14, 2.15, 2.16, 2.17, 2.18, 2.19, 2.20, 2.21, 2.22, 2.23 and 2.24) 2.4 Doppler (Figs. 2.25, 2.26, 2.27, 2.28, 2.29, 2.30, 2.31 and 2.32) 2.5 Tips and Tricks of Pelvic Ultrasound 2.6 Sonohysterography (SHG) 2.7 Gel Sonovaginography (GSV) Suggested Reading 3: Ultrasound Evaluation of Myometrium 3.1 Evaluation of Myometrium 3.2 Normal Myometrium (Figs. 3.8, 3.9 and 3.10) 3.3 Fibroids (Leiomyoma or Myoma) 3.3.1 Fibroid Mapping 3.3.1.1 Basics of Fibroid Mapping (Figs. 3.18, 3.19 and 3.20) 3.3.1.2 Site of Origin of a Fibroid (Figs. 3.21, 3.22 and 3.23) 3.3.1.3 Role of 3D in Fibroid Mapping (Figs. 3.24, 3.25 and 3.26) 3.3.1.4 Reporting of Fibroids/Fibroid Mapping (Figs. 3.27 and 3.28) 3.3.2 Red Degeneration (Fig. 3.29) 3.3.3 Fibroid Embolization (Figs. 3.30 and 3.31) 3.3.4 Diffuse Uterine Leiomyomatosis (Figs. 3.32 and 3.33) 3.3.5 Disseminated Peritoneal Leiomyomatosis (DPL) (Fig. 3.34) 3.4 Adenomyosis and Adenomyomas 3.4.1 Adenomyoma (Figs. 3.47 and 3.48) 3.5 Sarcoma Suggested Reading 4: Ultrasound Evaluation of Endometrium 4.1 Evaluation of Endometrium 4.2 Normal Endometrium 4.2.1 Endometrium in Paediatric Age Group (Fig. 4.10) 4.2.2 Endometrium in Reproductive Age Group (Figs. 4.11 and 4.12) 4.2.3 Endometrium in Postmenopausal Women (Fig. 4.13) 4.3 Endometrial Polyps 4.4 Endometrial Hyperplasia 4.4.1 Tamoxifen-Associated Endometrial Changes (Fig. 4.44) 4.5 Endometrial Malignancy 4.6 Differential Diagnosis of Thickened Endometrium (Fig. 4.56) 4.7 Asherman’s Syndrome or Intrauterine Adhesions 4.8 Subendometrial Fibrosis (Figs. 4.62 and 4.63) 4.9 Endometritis 4.10 Intracavitary Fluid in the Uterus (Figs. 4.69, 4.70, 4.71, 4.72, 4.73 and 4.74) Suggested Reading 5: Ultrasound Evaluation of the Cervix 5.1 Evaluation of the Cervix and Its Normal Appearance 5.2 Nabothian Cysts 5.3 Cervical Polyps 5.4 Cervical Fibroids (Figs. 5.15, 5.16 and 5.17) 5.5 Cervical Carcinoma Suggested Reading 6: Ultrasound Evaluation of the Vagina 6.1 Normal Vagina (Fig. 6.1) 6.2 Congenital Vaginal Anomalies 6.3 Vaginal Cysts (Figs. 6.2, 6.3, 6.4, 6.5, 6.6, 6.7) 6.3.1 Gartner Duct Cysts and Mullerian Cysts 6.3.2 Bartholin Gland Cysts 6.3.3 Skene Gland Cysts 6.4 Vaginal Masses and Vaginal Cancer 6.5 Other Vaginal Pathologies 6.5.1 Vaginal DIE 6.5.2 Foreign Body in the Vagina (Fig. 6.13) 6.6 Vulval Carcinoma (Fig. 6.14) Suggested Reading 7: Ultrasound Evaluation of Ovaries 7.1 Evaluation of Ovaries and Persistent Adnexal Masses 7.1.1 Morphology, Measurement and Doppler Evaluation of the Ovary and Ovarian Masses (Including Persistent Adnexal Masses) 7.1.2 Morphological Classification of Ovarian/Adnexal Masses (Fig. 7.14) 7.2 Normal Ovaries 7.3 Polycystic Ovaries (PCO) 7.3.1 PCO in the Absence of PCOS 7.4 Ovarian Masses 7.4.1 Functional or Physiological Cysts (Figs. 7.21, 7.22 and 7.23) 7.4.2 Endometriotic Cysts (Endometriomas) 7.4.2.1 Decidualised Endometriotic Cysts (Figs. 7.32 and 7.33) 7.4.3 Ovarian Neoplasms 7.4.3.1 Epithelial Tumours Serous Epithelial Tumours Serous Cystadenoma Borderline Serous Tumours Serous Cystadenocarcinoma Serous Cystadenofibroma (Figs. 7.41 and 7.42) Mucinous Cysts Mucinous Cystadenoma Borderline Mucinous Cysts Mucinous Cystadenocarcinoma 7.4.3.2 Germ Cell Tumours Dermoids (Mature Cystic Teratoma) Malignant Germ Cell Tumour Sex Cord–Stromal Tumours Granulosa Cell Tumour Sertoli and Sertoli–Leydig Cell Tumours Leydig Cell Tumours Fibromas and Fibrothecoma 7.4.3.3 Metastatic Ovarian Masses Suggested Reading 8: Endometriosis 8.1 Deep Infiltrating Endometriosis (DIE) Significance of DIE 8.1.1 DIE of Large Bowel (Rectosigmoid) 8.1.2 DIE of the Vaginal Wall 8.1.3 Cervical DIE 8.1.4 Uterosacral DIE (Figs. 8.10 and 8.11) 8.1.5 Bladder DIE 8.1.6 DIE Involving the Ureters (Figs. 8.13 and 8.14) 8.1.7 Uterus in Cases with DIE (Figs. 8.15 and 8.16) 8.2 Extra-Pelvic Endometriosis 8.2.1 Abdominal Wall Endometriosis 8.2.2 Abdominal and Thoracic Endometriosis (Fig. 8.20) Suggested Reading 9: Ultrasound Evaluation of Adnexal Pathology 9.1 Fallopian Tube 9.2 Pelvic Inflammatory Disease (PID) 9.3 Chronic PID 9.4 Hydrosalpinx 9.5 Tubal Malignancy 9.6 Paraovarian and Paratubal Cysts 9.7 Peritoneal Inclusion Cysts Suggested Reading 10: Ultrasound Evaluation of Pregnancy-­Related Conditions 10.1 Ectopic Pregnancy 10.1.1 Tubal Ectopic Pregnancy 10.1.2 Interstitial Ectopic Pregnancy 10.1.3 Cornual Ectopic Pregnancy 10.1.4 Ovarian Ectopic Pregnancy 10.1.5 Cervical Ectopic Pregnancy 10.1.6 Scar Ectopic Pregnancy 10.1.7 Intra-abdominal Pregnancy (Fig. 10.24) 10.1.8 Heterotopic Pregnancy (Figs. 10.25 and 10.26) 10.1.9 Intra-myometrial Ectopic Pregnancy (Fig. 10.27) 10.2 Retained Products of Conception (RPOC) 10.3 Gestational Trophoblastic Disease (GTD) 10.3.1 Molar Pregnancy 10.3.1.1 Molar Pregnancy: Complete Mole 10.3.1.2 Molar Pregnancy: Partial Mole 10.3.2 Gestational Trophoblastic Neoplasia (GTN) 10.3.2.1 Invasive Mole 10.3.2.2 Choriocarcinoma 10.3.2.3 Placental Site Trophoblastic Tumour (PSTT) and Epithelioid Trophoblastic Tumour (ETT) Suggested Reading 11: Torsion 11.1 Ovarian Torsion 11.2 Non-ovarian Torsion Suggested Reading 12: Ultrasound Evaluation of Congenital Uterine Anomalies 12.1 Embryopathogenesis (Figs. 12.1, 12.2) 12.2 AFS Classification of Uterine Anomalies (Figs. 12.2 and 12.3) 12.3 Approach to Diagnosing a Uterine Anomaly 12.4 Types of Uterine Anomalies 12.4.1 Arcuate Uterus (Fig. 12.10) 12.4.2 Subseptate Uterus (Fig. 12.13) 12.4.3 Septate Uterus (Fig. 12.14) 12.4.4 Bicornuate Uterus (Fig. 12.15) 12.4.5 Uterus Didelphys (Fig. 12.16) 12.4.6 Unicornuate Uterus (Fig. 12.17) 12.4.7 Absent/Hypoplastic Uterus (Figs. 12.18 and 12.19) 12.4.8 ‘T-Shaped’ Uterus (Fig. 12.20) 12.5 Cervical and Vaginal Anomalies (Figs. 12.16e, 12.21, 12.22, 12.23, 12.24, 12.25, 12.26, 12.27, 12.28 and 12.29) 12.6 ESHRE/ESGE Classification of Congenital Uterine Anomalies 12.7 Reporting Uterine Anomalies (Fig. 12.31) Suggested Reading 13: Ultrasound in Other Miscellaneous Conditions 13.1 Uterine Vascular Abnormalities (Arteriovenous Malformations) 13.2 Perforation of the Uterus 13.3 Vesicouterine Fistula 13.4 Retroflexed Uterus 13.5 Caesarean Scar Defect (LSCS Scar Defect) 13.6 Intrauterine Contraceptive Device (IUCD) 13.7 Follicular Monitoring and Ultrasonography in Patients with Infertility (Figs. 13.26 and 13.27) 13.7.1 Cyclical Changes During Menstrual Cycle (Both Natural and Induced) (Figs. 13.26 and 13.27) 13.7.2 Types of Scans Done in Patients Presenting or on Treatment for Infertility 13.7.3 Luteinised Unruptured Follicle (Fig. 13.28) 13.8 Ovarian Hyperstimulation Syndrome (OHSS) Suggested Reading 14: Exploring Pathologies Based on Clinical Presentation 14.1 Abnormal Uterine Bleeding 14.1.1 Common Forms of Abnormal Uterine Bleeding 14.1.2 Abnormal Uterine Bleeding in the Reproductive Age Group 14.2 Pelvic and Adnexal Masses 14.2.1 Ovarian Masses 14.2.2 Uterine Masses 14.2.3 Tubal Masses 14.2.4 Tubo-ovarian Masses 14.2.5 Paraovarian Masses 14.2.6 Pseudoperitoneal or Peritoneal Inclusion Cysts 14.2.7 Pelvic Hematomas and Pelvic Abscess 14.2.8 Non-gynecological Masses (Fig. 14.5) 14.2.9 IOTA Recommendation for Evaluation of Persistent Adnexal Masses 14.2.9.1 Simple Rules (Figs. 14.6 and 14.7) 14.2.9.2 Simple Descriptors (Figs. 14.8 and 14.9) 14.2.9.3 Three-Step Strategy for Evaluating the Nature of Persistent Adnexal Masses (Ameye et al. 2012) 14.3 Acute Pelvic Pain 14.4 Locating the Pregnancy and Pregnancy of Unknown Location (PUL) Suggested Reading Index