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Protocol
Patient should have a full bladder for transabdominal & empty bladder for transvaginal
If transvaginal examination order, do a brief survey of the pelvis with a transabdominal approach first
Scan through the entire pelvis in both planes prior to storing any images:
Begin in the transverse plane starting at the symphysis pubis
Scan upward through the fundus, evaluating the uterus and surroundings
DO NOT ANGLE the probe while scanning up, your transducer should move up the body
Return to the mid body of the uterus and turn into the sagittal plane
Scan right to left and evaluate the uterus and surrounding structures fluid.
Normal Measurements
Tips
You should scan through the pelvis and abdomen to perform a brief survey of the pericolic recesses and
hepatorenal and splenorenal spaces to look for fluid.
You may need to apply pressure to the pelvis with the transducer in order to see ovaries. If transducer pressure is
not working, pressure can be applied with your hand or by having the patient press down on themselves
Look for free fluid in the posterior cul-de-sac
Utilize 3D or 4D imaging to aid in pathology and endometrium shape details
Ovaries are located between the uterus and the iliac vessels
Pelvic muscles may mimic ovaries, evaluate structures in both planes prior to storing the image
Patient Information
Document first day of the last normal menstruation cycle
Document if postmenopausal patient is currently on hormone therapy
Document all symptoms in detailarea of pain, length of pain or bleeding, amount of bleeding, etc.
Document clinical history of pregnancies, surgeries, or previous pathologies
Pathology
Gray scale sagittal and transverse images
Gray scale sagittal and transverse images with 3 measurements (length x width x A/P)
Use Color Doppler to document the presence of blood flow and Spectral Doppler to document type and velocity
of blood flow
MR: Foundations\OBGYN\Lab\Protocols\ Pelvis Protocol r16.docx