2: Imaging in obstetrics and gynaecology Flashcards
What is the most common imaging used in gynaecology?
USS
What presenting complaints in women would indicate pelvic imaging?
Pelvic pain
Pelvic mass
Dodgy bleeding (intermenstrual, post-menopause)
Infertility
Which gland is commonly involved in male/female infertility?
How is it imaged?
Pituitary gland
MRI pituitary
What are two ultrasound views used for pelvic imaging?
Transabdominal
Transvaginal
Transabdominal ultrasound is (invasive / non-invasive).
non-invasive
Transvaginal ultrasound is (invasive / non-invasive).
invasive
It’s inserted
Gas appears as which colour on ultrasound?
Black
Gas appears black on ultrasound. This presents a problem in transabdominal ultrasound scanning.
How is this solved?
Full bladder
Shifts gas-filled bowel out of the way and acts as a reference point
In transvaginal ultrasound, where a probe is inserted into the vagina, the patient’s bladder needs to be (empty/full).
empty
Can transvaginal ultrasound be used in patients who haven’t been sexually active?
No
What colour does the endometrium appear on ultrasound?
White
What colour is free fluid on ultrasound?
Black
What imaging is used second-line in more complicated cases or to stage malignancies?
CT scan
What are the advantages of CT scanning over X-ray?
Multiple views, can scroll to select different slices
Higher resolution image
Can pick out more structures
CT scanning delivers a high dose of ___.
radiation
especially to testes/ovaries
Does MRI give the patient a dose of radiation?
No
But there are different risks (metal)
What are the two different MRI scans which patients can have?
T1
T2
relearn the difference
Which scan is used to stage cervical cancer?
Why?
MRI scan
CT not detailed enough
What colour does the endometrium appear on MRI?
White
What scan offers the most detailed image of the pelvis?
MRI scan
What scan is used to diagnose endometriosis?
MRI scan
As with normal endometrium, abnormal (& bleeding) tissue appears white
Which serial X-ray technique can be used to assess a woman’s tubal patency?
Hysterosalpingography (HSG)
Like an angiogram for the uterine tubes
Which is injected into the cervix before HSG is carried out?
Contrast
What is seen lateral to the uterus and uterine tubes once contrast has been injected in HSG?
Peritoneal spill
If uterine tubes are patent, contrast will pass through them and pass into peritoneal cavity at the distal end
Where does ovarian cancer tend to spread?
Why?
Peritoneal cavity
Space between ovaries and start of uterine tubes - continuous with “ “
Where in the body does ovarian cancer tend to spread?
Peritoneal cavity
Liver SURFACE (not intrahepatic)
What can be used to differentiate bowel from solid deposits on a CT or MRI scan?
Contrast
Which specific type of scan is used to identify cervical cancer?
MRI scan
T2-weighted
