Chapter 10: Doppler Evaluation of the Pelvis

• Pulsatility index:

  Doppler measurement that uses peak systole minus peak diastole divided by the mean
• Ovarian vessels:

  Blood vessels that supply oxygenated blood to and drain deoxygenated blood away from the ovaries
• Arteriovenous malformation:

  Abnormal connection between veins and arteries
• Impedance indices:

  Measurements used to compare the resistance of a medium to propagation of flow
• Uterine artery:

  Main vessel carrying oxygenated blood toward the uterus
• S/D ratio:

  Difference between peak systolic value and end- diastolic values of vessel
• Pourcelot resistive index:

  Doppler measurement calculated by the value of the highest systolic peak minus the value of the highest diastolic peak divided by the highest systolic peak
• Adnexa:

  Anatomical parts added, attached, or adjunct to another or others
• Secretory phase:

  Days 15 to 28 of the menstrual cycle
• Proliferative phase early:

  Days 5 to 9 of the menstrual cycle
• Arcuate vessels:

  Small vascular structures found along the periphery of the uterus
• Angiogenesis:

  Physiologic process involving the growth of new blood cells from preexisting vessels
• Proliferative phase late:

  Days 10 to 14 of the menstrual cycle
• Resistive index:

  A sonographic indicator of an organ to perfusion; calculated from the peak systolic velocity and the end - diastolic velocity of blood flow
• Specular reflectors:

  When the sound wave encounters a distinct surface that is larger than the wavelength of the ultrasound beam
• Malignant tumours, benign timours, and inflammatory conditions are not related to:

  hypoxia
• Use the lowest possible sonographic exposure settings to gain the necessary diagnostic information. True or false ?

  True
• What is the most appropriate transducer frequency for a transabdominal pelvic sonogram when more depth penetration is needed ?

  Lower frequency
• A full urinary bladder enhances uterine visualization, but frequently causes a suboptimal ____ _____ Doppler exam owing to the angle of incidence.

  uterine artery
• If a cystic mass is suspected during a full bladder pelvic ultrasound, the patient should:

  void the urinary bladder and further investigate the pelvis
• Which position provides the best visualization of free fluid in the pouch of Douglas during an endo-vaginal ultrasound examination ?

  Lithotomy with a slight reverse Trendelenburg
• With constant perfusion pressure, the flow ___ as the impedance to flow ___.

  increases, decreases
• Resistive index (RI) calculates:

  the peak systolic velocity to the end - diastolic velocity
• Suspicion for vascular occlusion occurs when a:

  high resistance pattern is detected where low resistance is normally seen
• A correct angle of ____ is required when analyzing vascular flow to determine its velocity by a Doppler.

  less than 60
• Normal arterial flow is seen as:

  alternating quick uptake systolic peak followed by a lower diastolic flow
• What is laminar flow ?

  Blood velocity traveling highest in the mid vessel
• Name the vessel (appearing a tubular structure) often seen sonographically in the outer uterine myometrium.

  Arcuate artery
• The functional layer of the endometrium is supplied blood by the what ?

  radial and spiral arteries
• An arteriovenous malformation (AVM) is typically acquired through:

  surgery or trauma
• Pelvic congestion is frequently diagnosed in nulliparous women. True or false ?

  False
• Describe classic ovarian torsion.

  An enlarged, edematous ovary with multiple small peripheral follicales and little to no vascular flow
• Complex cysts of the pelvis are difficult to discriminate because:

  benign and malignant characteristics can be similar
• Doppler ultrasound is vital component in the evaluation of pelvic pathology and physiology. True or false ?

  True
• Following a transvaginal examination, clean the transducer with an ______ solution.

  antimicrobial
• A sonographer must question every patient about allergies to what ?

  latex
• The ovarian vein diameter in nulliparous women is ___m and can be up to ___ mm in women who have had children.

  2.6 , 3.4
• The acronym BART means:

  Blue, away; red, towards
• The ovarian artery anastomoses with the ____artery at the uterine cornua.

  uterine
• Mid-luteal phase uterine arterial flow mean values in premenopausal patients are similar to that of _______ patients.

  post - menopausal