Re: Uterine arteries vs ovarian
From: Terry DuBose (terrydubose@sbcglobal.net)
Mon Jun 13 08:15:51 2005
I understand that the endovaginal approach is best. But my real question is simply an anatomical one... I teach anatomy. I simply can not reconcile the medical illustrations in Gray's Anatomy, Frank H. Netter, and others with the sonographic literature that says the uterine artery is Dopplered (transabdominal) where it crosses the external iliac artery and vein. I am simply trying to imagine how that can be… it more an academic question than a physiologic one. It is starting to appear that the uterine artery crosses over the external iliacs only during pregnancy.
Terry
"art fougner, md" <evsono@pipeline.com> wrote:
IN nonpregnant patients, best to insonate the uterine arteries using a
vaginal rather than abdominal approach... possibly also at the
midtrimester scan ... at which time, the cervix could also be
evaluated.
art
At Fri, 10 Jun 2005, DuBose, Terry wrote:
>
>I agree, but these measurements are sometimes taken in the non-pregnant
>patient. Because so many international luminaries Doppler the uterine
>arteries, I have only a small doubt about the methods. However, when I
>look in textbooks at the placement of the various arteries, it seems
>impossible for the uterine artery to cross both the external iliac
>artery and vein so consistently.
>
>I have not seen an explanation that is clear to me yet. Thanks Terry
>
>Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>
>Associate Professor & Director
>Diagnostic Medical Sonography Program
>University of Arkansas for Medical Sciences, CHRP
>4301 West Markham St. Mail Slot #563
>Little Rock, Arkansas, 72205 USA
>501-686-6510
>DuBoseTerryJ@UAMS.edu
>http://www.io.com/~dubose/
>http://www.uams.edu/chrp/dms/default.asp
>http://www.obgyn.net/us/panel/panel.htm
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>-----Original Message-----
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>From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of
>---------------------------------------------------------------
>evsono@pipeline.com
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>Sent: Friday, June 10, 2005 7:17 AM
>To: Multiple recipients of list ULTRASOUND
>Subject: Re: Uterine arteries vs ovarian
>
>It would seem that the enlarged pregnant uterus affects anatomical
>relationships - it's the uterine artery.
>
>art
>
>At Thu, 9 Jun 2005, Allen Worrall wrote:
>>
>>Many more knowledgeable than I will answer, I hope, but I think the
>textbook is talking about the abdominal approach to the uterine artery,
>and on the abdominal approach is does appear that the uterine artery
>crosses the external iliac. However, the uterine artery is deep in the
>pelvis - I do not know why it does not appear deeper in the pelvis,
>perhaps something to do with the angle of insonation.
>>
>>Allen
>>
>>>>> ----- Original Message -----
>> From: DuBose, Terry
>> To: Multiple recipients of list ULTRASOUND
>> Sent: Thursday, June 09, 2005 10:13 AM
>> Subject: Uterine arteries vs ovarian
>>
>> I have an anatomical question. We have a new course and textbook:
>Hofer, Mattthias; Teaching Manual of Color Duplex Sonography, Thieme
>2001.
>>
>> On page 58 the text states that "The uterine artery is imaged lateral
>to the uterus at the site where it crosses over the external iliac
>artery and the external iliac vein."
>>
>> However, because the uterine artery originates from the internal
>iliac artery, it can not cross over the external iliac artery. I
>suspect that they are actually measuring the flow in the gonadal or
>ovarian artery, which originates higher in the abdomen from the aorta,
>where it crosses the iliac arteries.
>>
>> See DuBose, p. 347, Figure 16-1; or
>>
>> Curry & Tempkin, p. 264, Figure 16-20A.
>>
>> I remember Kevin Harrington, who worked with Stewart Campbell, also
>said measure the uterine artery. See:
>>
>http://www.obgyn.net/displaytranscript.asp?page=/avtranscripts/ISUOG98
>harrington
>>
>> My question is, are they really looking for the physiologic notch in
>early diastole in the uterine artery or is it the gonadal (ovarian)? Do
>we see the same notch in both the uterine and ovarian? Where exactly
>are they doing the Doppler?
>>
>> Any help appreciated. Thanks, Terry
>>
>> Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>>
>> Associate Professor & Director
>> Diagnostic Medical Sonography Program
>> University of Arkansas for Medical Sciences, CHRP
>> 4301 West Markham St. Mail Slot #563
>> Little Rock, Arkansas, 72205 USA
>> 501-686-6510
>> DuBoseTerryJ@UAMS.edu
>> http://www.io.com/~dubose/
>> http://www.uams.edu/chrp/dms/default.asp
>> http://www.obgyn.net/us/panel/panel.htm
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>
>--
>art fougner, md
>
> "If you don't know where you are going, you will wind up somewhere
>else."
>Lawrence Peter Berra
>
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
