TRUS imaging- some helpful hints

TRUS or transrectal ultrasound imaging is increasingly being used to investigate male infertility. The sonographic imaging of the prostate, vas deferens, seminal vesicles and ejaculatory ducts using TRUS is crucial in determing pathology of these parts of the male genito-urinary system. But often, the insertion of the endocavitary probe or Transrectal probe, causes considerable pain and hence non co-operation from the patient.
I have found this technique to be useful in almost all cases:
Ask the patient to breath in and out (deeply inspire and expire), and insert the transducer very slowly with each breath.
Another method: ask the patient to strain as though trying to defecate; this causes the anal sphincters to open and makes probe insertion easy.
Visit : http://www.ultrasound-images.com/prostate.htm

Internal jugular vein phlebectasia:

The internal jugular vein in this Color Doppler image shows mild dilatation in its proximal part.
The transverse section shows marked turbulence in this vein, which is unusual, and suggests some intrinsic pathology which in this case is the large diameter of the vein. Note that the vein is far greater in size than the Common carotid artery near it. You can read more on this topic by scrolling down to the case and images at:
http://www.ultrasound-images.com/vascular.htm

Another Color Doppler video of the ductus venosus

Another example of the normal ductus venosus. Demonstrating the short vessel (arrow heads) connecting the Umbilical vein to the inferior vena cava via the hepatic vein.
















This Duplex doppler image shows the typical 3 waves of the spectral trace of the normal Ductus.
For more details visit:
http://www.ultrasound-images.com/fetus-general.htm

The elusive fetal ductus venosus

This short Color Doppler video clip shows marked aliasing in the ductus venosus (arrow heads).
The still image below shows the spectral waveform so typical of the ductus in Duplex Doppler.

Succenturiate placenta- a short ultrasound video clip

This video clip shows an anteriorly located accessory lobe or succenturiate lobe of placenta in a 32 weeks pregnancy. Such a placenta is at increased risk of post partum (post delivery) retention of part of the placenta. The main part of the placenta is seen along the posterior wall of the uterus.
Check: http://www.ultrasound-images.com/placenta.htm for more images and and links on this topic.

Ultrasound- Spermatoceles versus epididymal cysts:

Left Epididymal cyst





























Right spermatocele:




























Spermatoceles are the commonest cystic lesions of the scrotum. Both spermatocele and simple cysts of the epididymis are often difficult to distinguish from each other purely on ultrasound. The main difference is usually presence of echogenic debris or particles in the fluid within the cystic mass; particles (inactive sperms) are present in spermatocele (see images above) whilst clear fluid is seen in simple cyst of the epididymis (top most images).
See: http://www.ultrasound-images.com/scrotum.htm
for more on this topic.