TO REVIEW: Trans-abdominal (TAUS), trans-labial (TLUS) and trans-vaginal (TVUS) approaches to vaginal US examination; Indications for US, 3DUS, CEUS, RTE and their limitations; US imaging of normal vagina; US imaging of congenital and acquired diseases of the vagina correlated to magnetic resonance imaging (MRI).

Vaginal diseases can be easily overlooked during a standard transabdominal US (TAUS)examination when there is no request for directed vaginal imaging. Even when performing a transvaginal US (TVUS), the sonographer usually begins the examination once the probe tip has reached the fornices, thus missing possible vaginal and peri-vaginal pathologies. It is essential to know the different US approaches which allow to investigate this anatomical region.

ULTRASOUND TECHNIQUES Transabdominal US (TAUS) requires moderate bladder distention to create an acoustic window for the visualization of the vagina. However, transabdominal transducers, which offer a wide field of view, allow an extensive overview of the pelvic region but with a lower resolution than with transvaginal US. Transvaginal US (TVUS) is performed with the patient in lithotomy position and the patient’s bladder completely empty, which brings the organs of interest closer to the higher-frequency transducer and improves image resolution Fig. 1 Fig. 2. The major...

Vaginal evaluation is rarely performed using TAUS and TLUS is not required routinely. Also, TVUS must be targeted to assess the vagina when there is suspicion for vaginal pathology; the sonographer have to monitor the probe during its penetration in the vagina from the introitus to fornices in order to demonstrate any parietal lesions that otherwise could be missed. US allows to detect also small lesions of the vagina. US is effective in the evaluation of benign vaginal pathology in association with biopsy if necessary....

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Giulio Ferrero, Department of Internal Medicine, Resident Radiologist, University of Genova ([email protected]) Emanuele Fabbro, Department of Internal Medicine, Resident Radiologist, University of Genova Francesca Lacelli, Department of Radiology, Santa Corona Hospital, Pietra Ligure (SV). Nadia Perrone, Department of Radiology, Santa Corona Hospital, Pietra Ligure (SV). Luca M. Sconfienza, Unit of Radiology, IRCCS Polyclinic San Donato, Milano. Giovanni Serafini, Department of Radiology, Santa Corona Hospital, Pietra Ligure (SV).