ULTRASOUND Messages for June, 2005: Re: Uterine arteries vs ovarian

Re: Uterine arteries vs ovarian

From: James Smeltzer

James.Smeltzer@wellstar.org

Mon Jun 13 12:50:59 2005

Jim

>>> DuboseTerryJ@uams.edu 6/13/2005 11:08:56 AM >>>

That helps a lot. I am starting to get an image (mind's eye) of how the vessel "starts laterally, swings anteriorly and crosses in front of the iliac artery." Will save some images the next time I look at a pelvis transabdominal. 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 ---------------------------------------------------------------

-----Original Message----- --------------------------------------------------------------- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of ---------------------------------------------------------------

-- James Smeltzer Sent: Monday, June 13, 2005 9:37 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Uterine arteries vs ovarian

Hi!

Looking for 3d of the vascular tree I stumbled on this 3d of the fetal brain: http://cds.ismrm.org/ismrm-2000/PDF2/0355.pdf

Here is a radiogram from a uterine embolization. Scroll down to see it. In the pblique lateral view you can see the catheter and it follows into the uterine. In comparison with the injection post embolization on the right you can clearly see that it starts lateraly, swings anteriorly and crosses in front of the iliac artery. These are not labeled but are clear to see. The first three angiographic images all demonstrate this phenomenon:

http://www.bocaradiology.com/Procedures/UFE.html

In this anatominc labeled dissection on our own web site, the external iliac is not labeled and has been removed but imagine where it was to see the crossing: http://www.obgyn.net/us/placenta-accreta/AN1.jpg

This one has the external in it but is harder to understand because of the angle: http://www.obgyn.net/us/placenta-accreta/AN2.jpg

Hope this helps!

Jim

James S. Smeltzer, MD, FACOG, SMFM Consultant, Maternal Fetal Medicine Wellstar Physicians' Group Northwest Women's Care 787 Campbell Hill St Marietta GA 30060 James.Smeltzer@wellstar.org VM 678-290-3035 Off 770-528-0260 Page 404-318-3451

>>> bouthina_ibrahim@yahoo.com 6/11/2005 6:59:30 AM >>>

thank you so much one arise ant to ECA IS UTERINE VESSEL NOTCHING IS PATHOLOGICAL???<DuboseTerryJ@uams.edu> 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

--------------------------------------------------------------- -----Original Message----- --------------------------------------------------------------- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of evsono@pipeline.com 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 > --------------------------------------------------------------- > > --------------------------------------------------------------- > =20 > --------------------------------------------------------------- > --------------------------------------------------------------- > > --------------------------------------------------------------- > ---------------------------------------------------------------

--
art fougner, md

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Lawrence Peter Berra

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