This is a descriptive presentation on the ultrasonography of female reproductive system as well as male reproductive system too,focusing on disease diagnosis through ultrasonographic images and pregnancy diagnonsis.

1. UltrasonographyUltrasonography
Sakina RubabSakina Rubab
99thth
semester, DVMsemester, DVM
UCV&ASUCV&AS
Islamia University of BahawalpurIslamia University of Bahawalpur

2. Ultrasound PhysicsUltrasound Physics
Characterized by sound waves ofCharacterized by sound waves of
high frequencyhigh frequency
 Higher than the range of humanHigher than the range of human
hearing (20-20000Hz)hearing (20-20000Hz)
 Diagnostic U/S = 1-20 MHzDiagnostic U/S = 1-20 MHz

3. ComponentsComponents
 Monitor/ DisplayMonitor/ Display
 Transducer/ ProbeTransducer/ Probe
 Control panelControl panel

4. Ultrasound machineUltrasound machine

6. Transcutaneous :Concave Image

7. Transrectal: Linear image

8. Transrectal probe
Transcutaneous
probe

9. Monitor
Control panel
U/S gel

10. PrinciplePrinciple
ElectricityElectricity
TransducerTransducer
Ultrasound wavesUltrasound waves
TissueTissue
TransducerTransducer
ImageImage

11. TypesTypes
 DopplerDoppler
 A mode: (Amplitude) One dimensionalA mode: (Amplitude) One dimensional
 B mode: (Brightness) Two dimensionalB mode: (Brightness) Two dimensional
 Real time B mode:Real time B mode: motion can be seenmotion can be seen

12. Ultrasound of the FemaleUltrasound of the Female
Reproductive SystemReproductive System

13. Transcutaneous Ultrasonography in a pregnant doe

14. Ultrasonographic image of a fetus

15. TechniqueTechnique
 7.5-10mHz transducers7.5-10mHz transducers
 5 mHz in mid to late term pregnancy,5 mHz in mid to late term pregnancy,
pyometra, ovarian tumorspyometra, ovarian tumors
 Dorsal recumbency is routineDorsal recumbency is routine
 Larger animals standingLarger animals standing
 Full bladder enhances visualization ofFull bladder enhances visualization of
uterusuterus
 Acoustic windowAcoustic window

16. How is interpretation done?How is interpretation done?
 AnechoicAnechoic BlackBlack
 HypoechoicHypoechoic GreyGrey
 HyperechoicHyperechoic WhiteWhite

17. Types/Frequency ofTypes/Frequency of
TransducersTransducers
 TransrectalTransrectal
 TranscutaneousTranscutaneous

18. Transrectal TransducerTransrectal Transducer
 7.5 MHz------- Early pregnancy diagnosis7.5 MHz------- Early pregnancy diagnosis
 5 MHz -------- Pregnancy diagnosis after5 MHz -------- Pregnancy diagnosis after
4040 daysdays
 3.5 MHz--------Late pregnancy diagnosis;3.5 MHz--------Late pregnancy diagnosis;
early pregnancyearly pregnancy
diagnosisdiagnosis

19. Transcutaneous TransducerTranscutaneous Transducer
 3.5 MHz--------Late pregnancy diagnosis3.5 MHz--------Late pregnancy diagnosis

20. Normal Ultrasound AnatomyNormal Ultrasound Anatomy
 OvaryOvary
 Mix of hyper and hypo echoic signalsMix of hyper and hypo echoic signals
 Difference can be made between small inactive andDifference can be made between small inactive and
large active ovaries.large active ovaries.
 C.LC.L
 Different from ovarian stromaDifferent from ovarian stroma
 Hypo echoic relative to the ovarian stromaHypo echoic relative to the ovarian stroma
 Undefined borderUndefined border
 Vary according to the stage of pregnancy andVary according to the stage of pregnancy and
developmentdevelopment
 C.L of pregnancy usually have the cavity in it, appearsC.L of pregnancy usually have the cavity in it, appears
anechoicanechoic

21.  FolliclesFollicles
 Waves of follicles can be followed for theirWaves of follicles can be followed for their
development and regression.development and regression.
 2mm follicles are considered to be smallest one;2mm follicles are considered to be smallest one;
anechoic structures as they growanechoic structures as they grow
 Shape: can be Oval, asymmetrical, round.Shape: can be Oval, asymmetrical, round.
 OvulationOvulation
 Appearance of large follicle and then disappearanceAppearance of large follicle and then disappearance
 Timing of the ovulation can be determined as sizeTiming of the ovulation can be determined as size
increasesincreases
 Ovulation seen as pear shaped structure with pointingOvulation seen as pear shaped structure with pointing
 4 min period for evacuation of fluid from follicle4 min period for evacuation of fluid from follicle

22.  Ovarian Blood VesselsOvarian Blood Vessels
 Appear as small, medium follicles 2-5 mm inAppear as small, medium follicles 2-5 mm in
sizesize
 Altering the plane of scanning they move andAltering the plane of scanning they move and
their shape changes.their shape changes.
 They becomes elongated from oval orThey becomes elongated from oval or
rounded shaperounded shape

23.  Uterine HornUterine Horn
 Scan both cross and longitudinal sectionScan both cross and longitudinal section
 Outlined by dark ring which is a vascular coatOutlined by dark ring which is a vascular coat
 Changes due to physiological statesChanges due to physiological states
 Caruncles on the endometrial sizeCaruncles on the endometrial size
 Uterine BodyUterine Body
 Longitudinal axis view; rotate the probe inLongitudinal axis view; rotate the probe in
clockwise and anti clock wise direction to seeclockwise and anti clock wise direction to see
the bifurcationthe bifurcation

24.  CervixCervix
 Hyper echoic imageHyper echoic image
 External os can be seenExternal os can be seen
 VaginaVagina
 Hyper echoic; ovoid; fluid filledHyper echoic; ovoid; fluid filled
 Urinary bladderUrinary bladder
 AnechoicAnechoic
 Confusion with pregnancyConfusion with pregnancy

25. Pregnancy diagnosisPregnancy diagnosis
 DaysDays
 Structures SeenStructures Seen
 17-1917-19
 C.L and Little anechoic lumen in ipsilateral hornC.L and Little anechoic lumen in ipsilateral horn
 22-2422-24
 Anechoic lumen increasesAnechoic lumen increases
 Echogenic streaksEchogenic streaks
 Heart beatHeart beat

26.  DaysDays
 Structures SeenStructures Seen
 3030
 More pronounced changes presentMore pronounced changes present
 MembranesMembranes
 3535
 Uterine carunclesUterine caruncles
 CRLCRL

27.  Day 49-52 of gestationDay 49-52 of gestation
 Considerable skill is requiredConsiderable skill is required
 7.5MHz (cross and dorsal plane)7.5MHz (cross and dorsal plane)
 Genital tubercle is the target structure fromGenital tubercle is the target structure from
which penis and clitoris is formedwhich penis and clitoris is formed
 At day 42 structure begin to migrate fromAt day 42 structure begin to migrate from
perineum to Anusperineum to Anus
 In female, migration does not occur genitalIn female, migration does not occur genital
tubercle is located caudal to pelvic limbstubercle is located caudal to pelvic limbs

28. Ovarian StructuresOvarian Structures

29. PyometraPyometra
 U/S is modality of choice forU/S is modality of choice for
DxDx
 Enlarged uterus & uterineEnlarged uterus & uterine
hornshorns
 Luminal contentsLuminal contents
 Homogenous, anechoicHomogenous, anechoic
 Echogenic, “swirling”Echogenic, “swirling”
 May see varying wall thicknessMay see varying wall thickness
 Endometrium may containEndometrium may contain
anechoic focianechoic foci
 Ddx: hydrometra, mucometraDdx: hydrometra, mucometra
 Monitor response to therapyMonitor response to therapy

30. 18 day pregnancy18 day pregnancy

31. OrganogenesisOrganogenesis
FetalFetal
StructureStructure
Days PostDays Post
LH SurgeLH Surge
Fetal orientationFetal orientation 2828
Limb budsLimb buds 3535
SkeletonSkeleton 33-3933-39
Stomach, bladderStomach, bladder 35-3935-39
LungsLungs 38-4238-42
Kidneys, eyesKidneys, eyes 39-4739-47
Cardiac chambersCardiac chambers 4040
IntestinesIntestines 57-6357-63

32. Ultrasonography of MaleUltrasonography of Male
Reproductive SystemReproductive System

33. ProstateProstate
NormalNormal AbnormalAbnormal

35. Prostate DiseasesProstate Diseases
 Benign ProstaticBenign Prostatic
HyperplasiaHyperplasia
 Older intact dogsOlder intact dogs
 SymmetricalSymmetrical
enlargementenlargement
 May be up to 4 timesMay be up to 4 times
normalnormal
 Variable echogenicityVariable echogenicity
and textureand texture
 ProstatitisProstatitis
 Acute or chronicAcute or chronic
 Symmetrical orSymmetrical or
asymmetricalasymmetrical
 HeterogenousHeterogenous
appearanceappearance
 May see hypoechoicMay see hypoechoic
areas (cyst orareas (cyst or
abscess)abscess)
 Mineralization, fibrosisMineralization, fibrosis

36. Prostate DiseasesProstate Diseases
 NeoplasiaNeoplasia
 Older neutered dogsOlder neutered dogs
 EnlargedEnlarged
 Irregular shapeIrregular shape
 Texture variesTexture varies
 Hyperechoic foci withHyperechoic foci with
acoustic shadowing =acoustic shadowing =
mineralizationmineralization
 May see cyst-like lesionsMay see cyst-like lesions
 CystsCysts
 Developmental orDevelopmental or
congenitalcongenital
 Anechoic contentsAnechoic contents
 Thin hyperechoic wallThin hyperechoic wall
 Vary in size and numberVary in size and number

37. Prostatic CystProstatic Cyst

38. TestesTestes
 Homogenous textureHomogenous texture
 Parietal and visceral tunics:Parietal and visceral tunics:
 hyperechoichyperechoic
 Mediastinum testis:Mediastinum testis:
 Echogenic linear structure on midlineEchogenic linear structure on midline
 Tail of the epididymisTail of the epididymis
 Nearly anechoicNearly anechoic
 Coarse echotextureCoarse echotexture

39. Testicular NeoplasiaTesticular Neoplasia
 Interstitial, Sertoli cell, seminomaInterstitial, Sertoli cell, seminoma
 May all appear the sameMay all appear the same
 Mixed appearance on U/SMixed appearance on U/S
 HemorrhageHemorrhage
 NecrosisNecrosis

40. Testes-cont’dTestes-cont’d
 Retained testesRetained testes
 Small sizeSmall size
 Caudal to kidneys toCaudal to kidneys to
inguinal canalinguinal canal
 Difficult to see on U/SDifficult to see on U/S
 OrchitisOrchitis
 Patchy, hypoechoicPatchy, hypoechoic
parenchymaparenchyma
 Hyperechoic if chronicHyperechoic if chronic
 EpididymalEpididymal
enlargementenlargement
 AbscessesAbscesses
 Irregular shapedIrregular shaped
 Hypoechoic contentsHypoechoic contents
 May look likeMay look like
neoplasia!neoplasia!

41. AdvantagesAdvantages
 NoninvasiveNoninvasive
 PainlessPainless
 Widely available, easy-to-use and lessWidely available, easy-to-use and less
expensiveexpensive
 Safe and does not use any ionizing radiationSafe and does not use any ionizing radiation
 Clear picture of soft tissues than x-ray images.Clear picture of soft tissues than x-ray images.

42. LimitationsLimitations
 Quality depends on skills of operatorQuality depends on skills of operator
 Overweighed patients not clear image ofOverweighed patients not clear image of
target organstarget organs
 Can not be used through bone or gasCan not be used through bone or gas

48. ReferencesReferences
 www.ncbi.nlm.nih.gov/pubmed/17688602www.ncbi.nlm.nih.gov/pubmed/17688602
 www.tandfonline.com/doi/pdf/10.1081/E-www.tandfonline.com/doi/pdf/10.1081/E-
EBAF-120047343EBAF-120047343
 www.researchgate.net/...www.researchgate.net/...UltrasonograpUltrasonograp
hichic......smallsmall__ruminantruminant__reproductionreproduction
 http://onlinelibrary.wiley.com/doi/10.1111/j.http://onlinelibrary.wiley.com/doi/10.1111/j.
1439-0531.2010.01640.x/full1439-0531.2010.01640.x/full

49. Thank youThank you