title: Laparoscopy-assisted intrapelvic sonography with a high-frequency, real-time miniature transducer to assess the ovary: a preliminary report.
abstract: OBJECTIVE
  Our purpose was to evaluate the normal and pathologic internal textures of the ovary using laparoscopy-assisted intrapelvic sonography (LAIPS) with a specially developed 20-MHz flexible catheter-based high-resolution real-time miniature (2.4 mm in outer diameter) ultrasound transducer in patients with gynecologic disorders and infertile women.
  
  
  METHODS
  30 women (19 patients with gynecologic disorders and normal menstrual cycles (2 adenomyoses, 1 cervical cancer, 5 fibromyomas, 5 simple ovarian cysts, 1 endometriosis, 3 benign cystic teratomas, and 2 endometriomas), and 11 patients with infertility including 4 with polycystic ovarian syndrome, PCOS) were studied by intrapelvic sonography using a high-frequency real-time miniature transducer with pelvic saline effusion and laparoscopy.
  
  
  RESULTS
  In the normal ovary in the mid-follicular phase, follicles were depicted more distinctly than with transvaginal sonography (TVS). In the late-follicular phase, cumulus oophorus formations were visualized in 6 of 9 patients (54.5%), but were not clear using TVS. In the luteal phase, the corpus luteum was noted in 9 of 12 patients (75%) by both TVS and LAIPS. In patients with PCOS, the thickened capsule of the ovary was distinguished clearly especially in the peripheral type, in which numerous small cysts were aligned in the subcapsular region of the ovary, whereas it could not be detected by TVS. In all 4 cases with PCOS (8 ovaries), the ovarian capsular thickness could be measured by means of LAIPS. In subjects with benign cystic teratoma, minimal high echoic lesions were depicted. In subjects with endometrioma, a diffuse coarse-granular internal texture was visualized. However, depiction of internal structures in large pathologic ovarian lesions was markedly limited because of the shallow scanning range of the high-frequency transducer.
  
  
  CONCLUSIONS
  LAIPS with a high-frequency real-time miniature transducer might be a useful diagnostic modality to evaluate the normal physiologic textures of the ovary, as well as those with PCOS.
authors.affiliation: Department of Midwifery, Kagawa Prefectural College of Health Sciences, Mure, Kagawa, Japan. senoo@chs.pref.kagawa.jp
authors.forename: Daisaku
authors.initials: D
authors.lastname: Senoh
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Atsuko
authors.initials: A
authors.lastname: Shiota
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohno
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hata
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000000981:diagnostic imaging; D010053:Ovary / Q000000981:diagnostic imaging*; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging; D014159:Transducers; D014463:Ultrasonography / Q000379:methods*