"Posterior compartment "
"as the structures of the posterior compartment require little scanning depth, and the pathology assessed for is small, the highest frequency possible on the transvaginal transducer should be sought."
Expected headings
"Normal ultrasound anatomy"
"Anterior compartment"
"Posterior compartment "
"Assessment of the uterus and ovaries"
"Assessment for soft markers"
"Assessment of the sliding sign"
"Assessment of the anterior and posterior compartments"
"a small-to-moderate amount of physiological free fluid can be seen in the pouch of Douglas; this can be used as an acoustic window to visualise small (even superficial) lesions within the posterior compartment"
"uterosacral ligaments: the normal uterosacral ligaments are seen as a thin hyperechoic line or may not be seen at all; the midline joining point of the left and right uterosacral ligaments is the torus uterinus 2,3"
"with the transducer at the opening of the vagina, trace the lower rectum until the transducer is in the posterior vaginal fornix; continue to follow the longitudinal plane of the rectosigmoid colon until it can no longer be visualised (usually past the level of the uterine fundus and left ovary); repeat in the transverse plane"
"with the transducer at the opening of the vagina, trace the lower rectum until the transducer is in the posterior vaginal fornix; continue to follow the longitudinal plane of the rectosigmoid colon until it can no longer be visualised (usually past the level of the uterine fundus and left ovary); repeat in the transverse plane"
"with the transducer in the posterior fornix, move the transducer laterally and rotate slightly (30-45 degrees); the uterosacral ligaments will be seen in long axis as a thin white line immediately deep to the vaginal wall 3,4"
"when endometriosis is present, the uterosacral ligaments may appear thicker due to a thickening of the surrounding fat; a hypoechoic nodule may be present 4"
"mobility of the organs can be affected by the position of the ovaries, body habitus and pain tolerance; care should be taken when labelling an ovary immobile to insure this is pathological rather than technical"
"extensive deep endometriosis can cause significant distortion of the normal pelvic anatomy; if the exact location of a nodule cannot be definitively determined, describing as being located in the "anterior compartment" or the "posterior compartment" is most clinically helpful 1"
"visualisation of the bowel may be hindered by large pelvic masses (e.g. fibroids or endometriomas)"
"if using a three-dimensional mechanical transvaginal transducer, the steering or tilt function can be employed to assess places otherwise difficult to access comfortably (e.g. distal rectum)"