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\r\f\n\t\b\n\b\n\r\r\r Ultrasonography is the most frequently used imaging investigation in the assessment of the female genital tract. Most often Received Accepted 2011, Vol. 13, No 3, 249-252 „Dominic Stanca” Obstetrics and Gynecology Clinic, 55-57 21 Decembrie 1989 str Cluj-Napoca, Romania Fig 1. Endovaginal ultrasonography – normal appearance of the Fig 2. Transabdominal ultrasonography – uterus – normal as-pect, anteverted-ante�exed. Uterine measurements on a sagittal Fig 3. Transabdominal ultrasonography – evaluation of uterine thickness in a transverse view.Systematic sagittal and transverse images are ob-tained. These two types of views allow for a three-dimen-sional integration of the pelvic anatomy and are usually enough for establishing the diagnosis. Sometimes frontal The uterus represents the essential landmark of pelvic anatomy. The main aspects that can be evaluated through The position. Usually the uterus has a mid-central situation within the pelvis. A lateral position is seldom encountered and it is realized around the axis of the uter-ine isthmus. The anteverted-ante�exed uterus, with the uterine body found in the vesico-uterine space, is the most frequent situation compared with the retroverted-retro񦀆

2 C;exed uterus, when the uterine body is
C;exed uterus, when the uterine body is situated in The size. The following measurements are obtained during the ultrasound evaluation of the uterus: the length – the distance from the fundus to the internal ori�ce of the uterus on a sagittal view; the width – the maximum anterior-posterior distance measured in the mid portion of the uterine body also on a sagittal view; the thickness – the maximum distance measured at the level of the uterine fundus on a transverse view. The mean uterine measurements of a reproductive age patient are 70/35/50 mm, while the measurements for menopausal patient are The shape. 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 isth-mus is identi�ed where the uterine body and cervix meet. On the transverse view the uterine body has an oval shape, with a transverse long axis, while the isthmus and Medical Ultrasonography 2011; 13(3): 249-252Uterine ultrasonographic structure. The myometri-um has a homogeneous structure, with �ne, parallel, lin-ear echoes and an echogenicity similar to a muscle. The hyperechoic area in the middle is the uterine cavity and can not be measured (�g 4). The cavity line corresponds to the virtual interface that separates the layers of the en-dometrium. The endometrium is evaluated on a sagittal view. When the cavity line is present the endometrium is measu

3 red from the base of its anterior layer
red from the base of its anterior layer to the base of its posterior layer (double layer). When there is intrac-avitary retention only one layer of the endometrium is measured (single layer thickness) (�g 5, �g 6). The thick-ness and the echogenicity of the endometrium varies with the different stages of the menstrual cycle. The main characteristics of the ovary that can be as-The position. Usually the ovaries are found lateral from the uterus in the ovarian fossa, behind and inside the external iliac vessels. Sometimes the ovaries are asymmetrical and mobile and change their position as the uterus changes its own position with the degree of The shape. The ovary has an oval shape with the long axis oriented downward and forward. The ovaries have a �ne contour. The size. The measurements of the ovary are obtained after determining its long axis. Two distances (the length and the width) are measured in this view and a third one (the thickness) is obtained after rotating the transduc-ers with 90°. The mean measurements of the ovary are Ovarian ultrasonographic structure. The overall as-pect of the ovary is hypoechoic when compared with the myometrium. Through endovaginal ultrasound two dis- an echoic central area (corresponding to the stroma) a peripheral area (corresponding to the cortex) which contains the ovarian follicles in different develop-ment stages. The dynamics of ovarian structure may be Fig 5. Endovaginal ultrasonography

4 – endometrium thickness Fig 6. Endovag
– endometrium thickness Fig 6. Endovaginal ultrasonography – endometrium thickness Fig 7. Endovaginal ultrasonography – ovarian measurements on a) sagittal view (length, width); b) transverse view.Fig 8. Endovaginal ultrasonography – normal appearance of the ovary. evaluated during the spontaneous ovarian cycle or after The ultrasonographic exam of the uterus and ovaries Proper knowledge regarding the examination tech-nique as well as the ultrasound uterine and ovarian anat-omy is absolutely necessary for the integration of ultra-sonographic data in order to establish the diagnosis of the References Y. Ardaens, B. Guérindu Masgenêt, Ph Coquel. Echogra-en pratique gynecologique. Ed Masson 3 Edition, 2. Peter W. Callen. Ultrasonography in obstetrics and gyne-cology. Ed. Saunders Elsevier 5th Edition 2008: 887 – 917. Aurel Văleanu, Nicolae Costin, Dan Mihu. Ecogra�e abdominală şi pelvină. Ed. Arcadia 2005: 124 – 126. Keith Dewbury, Hylton Meire, David Cosgrove. Ultra-sound in obstetrics and Gynaecology. Ed. Churchill Living- A. Kurjak, F.A. Chervenak. Donald School Textbook of Ultrasound in Obstetrics and Gynecology. Jaypee Brothers Y. Ardaens, B. Guerin du Masgenet, P. Coquel, JM. Levail-lant, E. Poucelet. Echographie et imagerie pelvienne en pra- S. Kupesic. Color 3D/4D Ultrasound in Gynecology, Infer-tility and Obstetrics 2 Ed. Jaypee Brothers Medical Pub-lishers Ltd 2011: 19-20 K.A. Rao, H. Carp. The Infertility Manual. Jaypee Brother