Which is more accurate for gynecological B-ultrasound through the abdomen or vagina?

The accuracy of gynecological ultrasound examination needs to be selected according to the examination purpose and patient condition. Transvaginal ultrasound usually has higher resolution for the uterine adnexa, while transabdominal ultrasound is more suitable for those in the middle and late stages of pregnancy or those who are contraindicated for vaginal examination.

Transvaginal ultrasound, with its probe closer to the uterus and ovaries, can clearly display endometrial thickness, follicular development, and early pregnancy structure, making it particularly suitable for monitoring ovulation or evaluating endometrial lesions in infertility before 12 weeks of pregnancy. High frequency probes can detect small lesions with a diameter of less than 5 millimeters, such as small follicles or uterine polyps in polycystic ovary syndrome. But it is prohibited for patients with no sexual history, acute vaginal bleeding, or severe vaginitis. Abdominal ultrasound requires filling the bladder to push open the intestinal tract, which is suitable for observing large-scale structures in the pelvic cavity, such as fetal development in mid to late pregnancy, location of large uterine fibroids or ovarian cysts. However, the image quality may be limited for obese patients.

Both examination methods have their own focuses, with transvaginal ultrasound showing significant advantages in the diagnosis of gynecological fine structures, while transabdominal ultrasound is more suitable for overall evaluation and special populations. Before the examination, the doctor will comprehensively evaluate the patient's age, medical history, and examination purpose to select appropriate methods, and if necessary, use them in combination to improve diagnostic accuracy.

Before the examination, sexual intercourse or the use of vaginal medication should be avoided. Drinking water and holding urine should be done in advance for abdominal ultrasound. If the results are abnormal, it is recommended to combine gynecological examination and tumor markers for further evaluation. Regular gynecological ultrasound can detect lesions early, but the specific examination frequency should follow the doctor's advice to avoid excessive medical treatment.