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Conventional sonographic evaluation of the cervix and vagina is compromised by inattention, poor subject contrast, and obscuring artifacts. We describe a technique involving distention of the vaginal canal and fornices with ultrasound gel, providing an acoustic window for improved definition of the cervix and vagina. This exam is usually performed in concert with transvaginal sonography, but a transabdominal or transperineal approach may be more useful in selected scenarios. A wide variety of formerly sonographically inconspicuous conditions are demonstrable with this technique, many of which were undetected or inadequately characterized on the physical exam. Cervical polyps were the most commonly seen abnormality.

Objective: To assess the utility of a less invasive approach to the care of women with a pelvic abscess, we retrospectively reviewed the outcome of women with pelvic abscesses managed by transvaginal ultrasound-guided aspiration.Methods: A retrospective analysis of 27 pelvic abscesses in 22 consecutive women undergoing transvaginal drainage, including 13 tuboovarian abscesses (TOAs) and 14 postoperative abscesses (POAs). All patients received broad-spectrum intravenous antibiotics from the time infection was diagnosed to resolution of signs and symptoms. Chart review and examination of ultrasound files were utilized to extract demographic clinical, laboratory, and outcome data.Results: The mean age for the study group was 30 years old. Mean duration from diagnosis to drainage was 5.6 days (TOA) and 2.0 days (POA), P < 0.01. The mean diameter of the abscesses was 86 mm. The volume of purulent material drained ranged from 70–750 mL. Perceived adequacy of drainage was correlated with lack of abscess septation. Cultures for aerobic and anaerobic pathogens were positive in 51% of cases (79% POA versus 23% TOA, P < 0.05) with 1.9 organisms/ positive culture. Transvaginal drainage was successful in 25 of 27 abscesses. No complications were reported.Conclusion: In skilled hands, transvaginal guided aspiration of pelvic abscess is a highly successful technique with minimal risk to the patient. Follow-up studies are needed to assess the long-term sequelae, such as frequency of infertility, ectopic pregnancy, and chronic pelvic pain. Infect. Dis. Obstet. Gynecol. 7:216–221, 1999.

Purpose We report the gray-scale, color, and power Doppler findings in 3 cases of postpartum ovarian vein thrombophlebitis (PPOVT), an uncommon but potentially lethal disorder. Methods A retrospective review of medical records revealed 3 patients with PPOVT who had pelvic sonography performed during the disease course. Results The sonographic findings of PPOVT included a tubular, hypoechoic mass identified anterior to the psoas muscle in all cases. Perivenous phlegmon formation resulted in hydronephrosis and obstructive periureteritis in 1 case. Inferior vena cava involvement was detected in 2 cases. Decreases in the sizes of the thrombus and the phlegmon were seen on post-treatment studies. Conclusions The long course of the thrombosed ovarian vein and the presence of inferior vena cava thrombus are sonographic signs helpful in distinguishing PPOVT from other inflammatory conditions. Sonography cannot be proposed as a primary tool in the diagnosis of PPOVT because it successfully diagnosed only 1 of our 3 cases. However, sonography may be useful in monitoring the response to anticoagulant therapy. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound26:143–149, 1998.

An optical nanothermometer technique based on laser trapping, moving and targeted attaching an erbium oxide nanoparticle cluster is developed to measure the local temperature. The authors apply this new nanoscale temperature measuring technique (limited by the size of the nanoparticles) to measure the temperature of vapor nucleation in water. Vapor nucleation is observed after superheating water above the boiling point for degassed and nondegassed water. The average nucleation temperature for water without gas is 560 K but this temperature is lowered by 100 K when gas is introduced into the water. The authors are able to measure the temperature inside the bubble during bubble formation and find that the temperature inside the bubble spikes to over 1000 K because the heat source (optically-heated nanorods) is no longer connected to liquid water and heat dissipation is greatly reduced.