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Fig 1 a. – Standardized documentation of female perineal sonogram. (a) Longitudinal scan: with the transducer displayed at the bottom of the screen, caudal of the patient is seen at the lower edge and cranial at the top; the left side of the scan is ventral and the right side is dorsal. The same orientation is displayed in this standard MRI sagittal scan of female pelvis (b) |
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Fig 1 b. |
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Fig 2 a. Transperineal sonographic technique : with the transducer positioned on the sagittal scanning plane just under the symphysis pubis (position one) the typical appearances of the bladder, urethra and urethro pubic ligaments are displayed (a); |
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Fig. 2 b. – Moving probe handle anteriorly (position two), permits inclusion of the vaginal canal, utero-vesical junction and Douglas pouch (b) within ultrasound beam. |
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Fig. 2 c. – When transducer handle is moved even further anteriorly so that a vertical position (position three) is reached the end of transducer points more caudally and the anorectum is depicted together with the post-anal space ( c ). |
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Fig. 3 a. The scanning plane depicted in Fig. 2 c is rotated 90° counterclockwise until a short axis view of the anal canal is obtained which displays the internal and external anal sphincters (a), together with the mucosa-submucosa complex and the puborectalis muscle. |
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Fig 3 b. Then, the transducer handle is moved posteriorly to permit inclusion of the bladder, urethra and urethro-pelvic ligaments within ultrasound beam displayed on the coronal plane (b). |
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Fig 3 c. Occasionally, depending on proper inclination of the urethral axis, an axial view of the four-rings target like urethra is seen ( c ). |
