performed very much like a gynecologic exam, involves the insertion
of the transducer into the vagina after the patient empties her bladder.
The tip of the transducer is smaller than the standard speculum used
when performing a Pap test. A protective cover is placed over the
transducer, lubricated with a small amount of gel and then inserted
into the vagina. Only two to three inches of the transducer end are
inserted into the vagina. The images are obtained from different orientations
to get the best views of the uterus and ovaries. Doppler sonography
can also be performed through the transvaginal transducer, which is
the same transducer used during sonohysterography.
Transvaginal ultrasound is usually performed with the patient lying
on her back with her feet in stirrups as during a gynecologic exam.
The ultrasound image is immediately visible on a nearby screen
that looks much like a computer or television monitor. The radiologist
or sonographer watches this screen during an examination and captures
representative images for storage. Often the patient is able to
see the monitor as well.
For the transabdominal approach the patient has a full urinary
bladder and is positioned on an examination table. A clear gel is
applied to the lower abdomen to help the transducer make secure
contact with the skin. The sound waves produced by the transducer
cannot penetrate air, so the gel helps to eliminate air pockets
between the transducer and the skin. The sonographer then presses
the transducer firmly against the skin and sweeps it back and forth
to image the pelvic organs. Doppler sonography can also be performed
through the same transducer.