Adnexal and ovarian ultrasound provides detailed evaluation of the ovaries, fallopian tubes, and adnexal structures using transabdominal and transvaginal techniques. It is central to the diagnosis and management of ovarian cysts, pelvic masses, and gynecologic emergencies.
Sonographers assess ovarian size, follicular development, and cyst morphology using IOTA (International Ovarian Tumor Analysis) criteria — describing cyst contents, internal septations, papillary projections, and vascularity to estimate malignancy risk. Ovarian torsion is evaluated with color Doppler; absent or reversed diastolic flow supports the diagnosis of this surgical emergency. Ectopic pregnancy, tubo-ovarian abscess, and endometrioma are additional critical diagnoses made with adnexal ultrasound.
Adnexal sonography is covered under the ARDMS OB/GYN specialty within the RDMS credential. Sonographers in this field work in hospital emergency departments, OB/GYN practices, women’s imaging centers, and oncology units. Transvaginal technique is an essential skill, requiring careful patient communication and adherence to infection control protocols.