title: Sonography during early pregnancy: dependence of threshold and discriminatory values on transvaginal transducer frequency.
abstract: OBJECTIVE
  Our goal was to determine if normal and abnormal pregnancies could be distinguished at smaller sac sizes with a higher frequency transvaginal transducer than with a 5-MHz transducer.
  
  
  METHODS
  Thirty-nine patients with potentially abnormal pregnancies identified with a 5-MHz transvaginal transducer were immediately reimaged with a 9-5-MHz transducer. We compared our ability to visualize the yolk sac, embryo, and cardiac activity relative to mean sac diameter on imaging at both frequencies in women with normal and abnormal pregnancies.
  
  
  RESULTS
  Of the 39 pregnancies, 22 (56%) were normal or probably normal. Using the 5-MHz transducer, a yolk sac was first seen in a 6.4-mm gestational sac but was not definitively seen in 12 gestational sacs measuring 5-13 mm. Using the 9-5-MHz transducer, yolk sacs were identified in all gestational sacs measuring 4.6-13 mm, and live embryos were seen in five of eight sacs measuring 8.1-13 mm. The largest normal gestational sac without a live embryo measured 11 mm. When we compared these pregnancies with 17 (44%) abnormal pregnancies, we found that all pregnancies that had no yolk sac by the time the gestational sac measured 5.0 mm or no live embryo by 13 mm had abnormal findings on higher frequency imaging.
  
  
  CONCLUSIONS
  The ability to visualize the yolk sac and embryo in early pregnancy is critically dependent on transvaginal transducer frequency. Threshold values and discriminatory sizes used to distinguish normal and abnormal pregnancies are smaller on higher frequency than on lower frequency imaging and, therefore, should be redetermined for specific transducer frequencies.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Rowling
authors.forename: J E
authors.initials: JE
authors.lastname: Langer
authors.forename: B G
authors.initials: BG
authors.lastname: Coleman
authors.forename: H L
authors.initials: HL
authors.lastname: Nisenbaum
authors.forename: S C
authors.initials: SC
authors.lastname: Horii
authors.forename: P H
authors.initials: PH
authors.lastname: Arger
mesh_terms: D000293:Adolescent; D000328:Adult; D005321:Extraembryonic Membranes / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011261:Pregnancy Trimester, First; D016216:Ultrasonography, Prenatal / Q000295:instrumentation / Q000379:methods