SONOHYSTEROGRAPHY

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SONOHYSTEROGRAPHY

• KIM STERLING
• MS 112

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What is Sonohysterography?

• Many TA and TV ultrasound result in diagnoses of
  Thick endometrium
• Often Non-specific
• sonographicaly cant tell difference between
  Polyp, endometrial leomyoma, endometrial
  hyperplasia (focal or diffuse)
• Sonohysterography allows the ability for further
  evaluation of the uterine cavity

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Thickened endometrium
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Thickened Endometrium vs. normal Endometrium
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How is it Done?

• Patient Prep Empty bladder, take an Ibuprofen
• Role of Radiologist
• Insert speculum to expose cx
• Cleanse cx 3 times with iodine swab
• Insert catheter through side of
  speculum
  (so speculum can be removed)
• Remove speculum
• Insert TV probe(catheter still in
  place)
• Role of Sonographer
• Introduce 2-5mL of sterile saline
  via catheter to distend uterine cavity
• Follow standard protocol for
  performing a TV ultrasound

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When NOT to do sonohysterogram

• Patient may be pregnant
• Patient may have a vaginal infection

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What can it diagnose?

• Evaluation of pre and post menopausal
  bleeding
• Polyps
• Submucosal fibroid
• Intermural fibroid
• Endometrial hyperplasia
• Endo assessment for pts on Tamoxifen therapy
• Plays a role in fertility work up

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Endometrial Polyps during histerosonogram
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Transvaginally..With Saline
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Thickened es in 55y/ofound to be
Hyperplasia
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Using Doppler to Evaluate
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Submucosal (Intermural) Fibroid

• 2d image of thick endometrium
• 3d image finds a submucosal fibroid

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3d reconstruction Of Hysterosonogram

• 2d image of polyp
• 3d reconstruction of same polyp

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3d reconstruction

• 2d image
• 3d reconstruction showing polyp

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3d image of polyp
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Polyp during hist
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References

• http//www.obgyn.net/displayppt.asp?page/english/
  pubs/features/presentations/abdalla07/abdalla07-ss
  
• http//www.nufw.com.au/sonohyst.htm