Re: Uterine vs ovarian - James Smeltzer

From: James Smeltzer (James.Smeltzer@wellstar.org)
Wed Jun 15 12:16:59 2005


I prefer to call it urine-out-the-ears method..

Depends on how well you can see with what you got?!

JimS;^) >>> DuboseTerryJ@uams.edu 6/15/2005 12:33:39 PM >>>
"BTW don't try IP by TVS" So this is by the "full-bladder" transabdominal method?

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: Wednesday, June 15, 2005 11:30 AM To: Multiple recipients of list ULTRASOUND Subject: Re: Uterine vs ovarian - James Smeltzer

Depends on the patient, machine I'm on, tweaking the machine right and my patience level. Aloka 5000 thin usually Fat, GE 400 Never Voluson Expert Usually BTW don't try IP by TVS, better to look at the tubal vessel arcade that is the anastomosis of the uteroovarian via that route. The power doppler usually will give a better signal to acquire & then sort out arteries from veins with duplex.

I did not speak of phases of twisting, as this is all ischemic phase. Total obstruction is a no flow situation. This leads to the problem of documenting the absence of something - much harder than seeing it. This is exactly the same difference between a basic & targeted scan... JimS

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

>>> nattu@vsnl.com 6/15/2005 5:42:26 AM >>>

Dear Jim. Very interesting reading.......your mail. Esp. the Low indices during the initial phase of "twisting". How often do you trace the Inf. pelvic vessels under normal circumstances.?

Thanks for the details. LN.

Dr. Latha Natarajan, Physician and Sonologist, Bangalore, India.

>----- Original Message -----
From: "James Smeltzer" <James.Smeltzer@wellstar.org> To: "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net> Sent: Tuesday, June 14, 2005 9:33 PM Subject: Re: Uterine vs ovarian

> Hi,
>
> Just had a case of massive (10 cm) edema of a normal ovary with a
> partial torsion. Appearance was so bizarre and massive, and with a
very > LOW RI I thought it was a solid tumor. With a partial torsion,
> downstream from obstruction, you get (in carotids AND leg arteries
AND > ovaries) less pulsatile flow because you are observing low

resistance > runoff below the dam, and the tissue perfused is vasodilated because
of > the proximal obstruction. THis can be confused with a cancer flow
> signature - as I was confused. She had the ovary out.
>
> I believe that the partial torsion was primary. With total
obstruction > and infarction you get no flow. Trace the infundibulopelvic artery
& > vein with the color or power (if color not sensitive enough) on to
show > the vessels and the twisting of the partial torsion - at least this
is > what I plan to have sonographers do NEXT time they find massive
ovarian > size + low RI of the ovary. ;^}.
>
> Isn't ultrasound great - doing it 20 years and still get

surprised.... >
> Jim S
>
> 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
>
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