Following the long preface you have already read, I will let this book speak for itself. The main objective is to have a manual, come atlas, to take beginners through the questions why, how, and what to do first, before learning intricate ultrasound techniques. Within this objective come the following obligations:
  • Understand basic physics, and its utilisation during scanning,
  • Recognise the sonographic terminology,
  • Appreciate the different orientation during transabdominal and transvaginal scanning,
  • The ultrasound monitor and scanning plane are along the vertical axis during abdominal scanning,
  • The monitor should face the roof during vaginal scanning to have similar axis to the scanning plane,
  • Accordingly, it is technically impossible to get a transverse plane of the uterus during vaginal scans,
  • Appreciate normal anatomy, and how it is affected by disease,
  • Recognise artefacts during scanning,
  • Understand the legal obligations involved.
Having assimilated these important points, certain other principles should be followed strictly, to make them part of the daily repertoire:

  • Incorporate the learnt physics in machine optimisation,
  • Appreciate diagnostic potential and limits of ultrasound,
  • Always use the scanner to extend clinical judgment,
  • Think clinically and look for suspected pathology,
  • Know how to use your machine even in a dark room,
  • Should know the limits of your ability.

Last but by no means least, the following points should be incorporated in the departmental protol to be universally obligatory:

  • Ultrasound scan examinations should be performed for a proper indication,
  • The patient should be verbally consented,
  • The procedure should be explained,
  • Latex allergy should be ascertained in advance,
  • A chaperon should be available,
  • The patient should not be overexposed,
  • The examination should be done as gently as possible,
  • Proper documentation and explanation are obligatory.

All these points will be addressed in the different chapters of this book.
 On a different subject, many patients go to other clinics for second opinion, because of their initial physicians' remark was: 'let us have a quick scan'. Their point was that, nothing done quickly could be reliable, and must have cut corners. Let us do a proper scan, not a quick scan. Let us perform the scan when the patient is ready, both physically and psychologically.

To be able to offer practical guidance, I relied on my own long experience in ultrasonography to prepare this book. All the images used were generated from genuine cases, which I managed clinically. It is really a manual for ultrasound practice, rather than a textbook, and I hope it proves to be informative. Beside the initial theoretical information about rules and techniques, the reader will be taken, step by step, up the genital tract, in the gynaecology ultrasound section. The best ways of imaging each organ will be described, in the corresponding part in this section. Following that, I wrote specialised sections about the problems and pathologies we meet during our daily practice.

Finally, I hope younger gynaecologists who are thriving to become good ultrasonographers can take the quality of the images used in this manual as the minimum acceptable, and should thrive to have even better images. Using the proper technique and producing good images, can only help in providing better patients' care. I am not using any references in this book, contrary to the usual practice in routine textbooks, to verify one point or another. Instead, I am giving a list of books which I found useful over the years. Some are very dated, but still very useful as they deal with basic techniques.

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