✓ 14- Imaging in Male and Female Reproductive Systems and Breast Flashcards
How are chest radiographs relevant to gynecology?
- Pulmonary TB can affect the fallopian tubes + cause pelvic inflammatory disease leading infertility
- Pulmonary metastasis of ovarian or uterine carcinoma
What condition may cause pleural effusion?
Ovarian carcinoma
What is the first line of investigation for abdominal or pelvic masses?
US
What is the commonest type of masses seen in females?
Fibroids [intramura, Subserosal and Costal mucosal]
What imaging modality is used to asses the patency of Fallopian tubes?
Hysterosalpingography
What are the indications for Hysterosalpingography?
- Infertility: To demonstrate normal patency of fallopian tubes
- Recurrent abortion: To demonstrate congenital anomalies of uterine cavity
- Occlusion of sterilization procedure
- To demonstrate patency after sterilization reversal
- Post operatively after restoring patency of pathologically obstructed tube
Which imaging modality is used to investigate congenital anomalies?
US or MRI
What are the contraindications for Hysterosalpingography?
- Acute pelvic sepsis
- Sensitivity to contrast media
- Pregnancy
- Recent dilatation & curettage
- The week prior to and week following mensturation
What is the role of CT scan?
- Staging of malignant Gynecological tumors
- Primary diagnosis of pelvic tumors in cases which precludes ultrasound .
- Obesity
- Previous surgery
- Unstable bladder
- To demonstrate pelvic and retroperitoneal lymph nodes
- Liver metastasis
- Peritoneal seedings
Describe the imaging findings of Ovarian dermoids
- A soft tissue mass or A fat-containing mass of lower density
- Characteristic calcifications
- “Rim-like calcifications in ovarian cystic lesions”
Which imaging modality is the gold standard for malignancy and endometrium? Why?
MRI, has high soft tissue differentiation
Describe the appearance of Adenomyosis on an MRI?
- Diffuse or focal thickness of junctional zone
- Enlarged uterus with multiple hyper intense foci in myometrium representing hemorrhage
Describe the appearance of endometriosis on an MRI?
Multiple multiloculated cysts seen outside the uterine cavity
What imaging modality is highly accurate for adenomyosis?
MRI [high sensitivity and specificity]
Describe the appearance of endometriosis on an US?
- Homogenous low level echoes (highly suggestive)
- Unilocular/multilocul ar with septations
