Ultrasound of the Reproductive System
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Transcript Ultrasound of the Reproductive System
Ultrasound of the Reproductive
System
Stacy Fielding
Technique
7.5-10mHz transducers
Dorsal recumbency is routine
5 mHz in mid to late term pregnancy,
pyometra, ovarian tumors
Larger animals standing
Full bladder enhances visualization of
uterus
Acoustic window
Ovaries
Near caudal pole of kidney
1.5cm x 0.7cm x 0.5cm
Homogenous parenchyma
Cortex and medulla
Hard to differentiate
Cortex contains follicles
Ovaries-cont’d
Anestrus/early proestrus
Small, oval to bean shaped
Homogenous echogenicity (like renal cortex)
Follicles anechoic, become larger as ovulation
approaches
Diestrus
CL/CH has multifocal anechoic to hyperechoic
areas
Ovarian Structures
Ovaries
Cystic Ovaries
Anechoic
Thin walls
Acoustic enhancement
Solitary/multiple
Unilateral/bilateral
May see associated
pyometra or
hydrometra
Ovarian Neoplasia
Several kinds
Mostly unilateral
Smooth or irregular
margins
Variable appearance
MET CHECK!
Normal Uterus
Location: between urinary bladder and
descending colon
Various sizes
Uterine horns: 10-14cm x 0.5-1.0cm
Uterine body: 1.4-3cm x 3cm
Cervix: 1.5-2cm x 0.8cm
Solid, homogenous, relatively hypoechoic
May have thin hyperechoic border
Cannot differentiate layers
Normal Uterus-cont’d
Uterine horns not
easily identified
Lost in mesenteric fat
and small bowel
echoes
Cervix
Hyperechoic, linear
Pyometra
U/S is modality of choice for
Dx
Enlarged uterus & uterine
horns
Luminal contents
Homogenous, anechoic
Echogenic, “swirling”
May see varying wall thickness
Endometrium may contain
anechoic foci
Ddx: hydrometra, mucometra
Monitor response to therapy
Uterine Neoplasia
Adenomas
Leiomyomas
Leiomyosarcomas
Isoechoic to surrounding tissue, may
project into the lumen
Pregnancy Diagnosis
21-35 days after breeding
May be difficult to count fetuses
Radiography recommended late in gestation, following
mineralization
Earliest change = enlarging uterus
Remember conception can occur several days afterward
Non-specific
Gestational sac (blastocyst)
First confirmatory sign
Anechoic, several mm diameter
Thin, hyperechoic wall
17-20 d
18 day pregnancy
Pregnancy-cont’d
Embryo: 23-25 d
Yolk sac: 25-28 d
Oblong, echogenic, several mm
U-shaped echogenic structure
Extends across gestational sac
Zonary placenta: 27-30d
Thin hyperechoic layer surrounding
gestational sac
Fetal Viability
Cardiac activity
Day 35
Fetal resorption
Day 23-25 post LH
surge
Fluttering echoes
Fetal movement
before day 25
Embryonic fluid
becomes hypoechoic
Echogenic particles
Abortion
After day 35
Sonographic
appearance disappears
Organogenesis
Fetal
Structure
Days Post LH
Surge
Fetal orientation
28
Limb buds
35
Skeleton
33-39
Stomach, bladder
35-39
Lungs
38-42
Kidneys, eyes
39-47
Cardiac chambers
40
Intestines
57-63
(From Nyland & Mattoon)
Prostate
Caudal to bladder, at level of
trigone
Normal appearance varies
Age
Neuter status
Young to middle age intact
male:
Ventral to rectum
homogenous, moderate
echogenicity
Smooth margins, hyperechoic
rim
Prostatic urethra
Hypoechoic to anechoic round
structure on midline
Prostate Diseases
Benign Prostatic
Hyperplasia
Older intact dogs
Symmetrical
enlargement
May be up to 4 times
normal
Variable echogenicity
and texture
Prostatitis
Acute or chronic
Symmetrical or
asymmetrical
Heterogenous
appearance
May see hypoechoic
areas (cyst or abscess)
Mineralization, fibrosis
Prostate Diseases
Neoplasia
Older neutered dogs
Enlarged
Irregular shape
Texture varies
Hyperechoic foci with
acoustic shadowing =
mineralization
May see cyst-like lesions
Examine surrounding
structures!
Cysts
Developmental or
congenital
Anechoic contents
Thin hyperechoic wall
Vary in size and #
Paraprostatic Cysts
Muellerian duct remnant or
extension of lobe
Anechoic, fluid filled
May see swirlies
Variable wall thickness
May see compartments
Prostatic Cyst
www.merckvetmanual.com
Testes
Homogenous texture
Parietal and visceral tunics:
Mediastinum testis:
hyperechoic
Echogenic linear structure on midline
Tail of the epididymis
Nearly anechoic
Coarse echotexture
Testicular Neoplasia
Interstitial, Sertoli cell, seminoma
May all appear the same
Mixed appearance on U/S
Hemorrhage
Necrosis
May obliterate mediastinum testis +/epididymis
Testes-cont’d
Retained testes
Small size
Caudal to kidneys to
inguinal canal
Difficult to see on U/S
Orchitis
Patchy, hypoechoic
parenchyma
Epididymal
enlargement
Abscesses
Hyperechoic if chronic
Irregular shaped
Hypoechoic contents
May look like
neoplasia!