In my opinion, the time has come for all of us who perform
TVUS, or those who order
TVUS to do, or expect to be done, a dynamic assessment in real time looking for tenderness, decreased mobility and nonanatomically located ovaries (FIGURE 2).
Vikhareva Osser and colleagues, who performed both
TVUS and SIS in 108 women with a history of one or more cesarean sections.
(10-12) The data are from older studies, including a meta-analysis, that did not include the use of
TVUS. (10-12) But
TVUS is now in widespread use and included in the systematic review and meta-analysis this PURL addresses.
A total of 65 patients with adenomyosis suspicious on ultrasound underwent static pelvic MRI exams within 30 days of
TVUS between Jan.
Although our institutions' imaging with MRI and
TVUS is highly accurate, we additionally recommend the use of colonoscopy (with directed biopsies if appropriate) to evaluate patients who present with rectal bleeding, large endometriotic rectal nodules, or have a family history of bowel cancer.
Similarly, a single-arm prospective study in the United States looking at a two-stage screening strategy using ROCA and
TVUS showed comparable specificity and positive predictive values to those reported on UKCTOCS (Cancer 2013;119:3454-61).
When a woman who has tested positive for pregnancy presents with abdominal pain or vaginal bleeding and a normal intrauterine pregnancy (IUP) has not been confirmed by abdominal ultrasound, request a quantitative measurement of the [[beta]-hCG level and arrange for urgent
TVUS. (2,13) If pregnancy has been unsuspected in a patient with these symptoms, perform a urine test for pregnancy immediately and follow up with ultrasound.
The Bulletin went on to state that the primary imaging test of the uterus for the evaluation of AUB is
TVUS. (1) If
TVUS is not adequate, and if further evaluation of the cavity becomes necessary, hysteroscopy, preferable in an office setting, or SIS is recommended.
In a smaller study in which 97 women underwent
TVUS and EMB was attempted, researchers reported that while no cases of endometrial cancer were missed when EMB sampling was successful, there was only a 27% probability of obtaining an adequate endometrial sample in women with an endometrial thickness (ET) <5 mm.
If we have doubts about the bowel involvement even after
TVUS with bowel preparation, we recommend rectal echoendoscopy.
Although magnetic resonance imaging and transrectal or transvaginal ultrasound (
TVUS) may better visualize ovarian follicles, transabdominal ultrasound (TAUS) is a less invasive, cheaper, and more readily available imaging modality to diagnose PCOS, Dr.
Using a threshold of [less than or equal to] 5 mm, transvaginal ultrasound (
TVUS) can be used to identify those patients with postmenopausal bleeding who are at low risk for endometrial cancer, polyps, or atypical hyperplasia at a sensitivity comparable with that of endometrial biopsy and dilatation and curettage (D&C) (strength of recommendation: B, based on systematic reviews of consistent exploratory cohort studies.)