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Science of Repro > Imaging In Gynae > Flashcards

Imaging In Gynae Flashcards

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1
Q

How does an ultrasound work? (5)

A
  • Ultrasound waves and frequency
  • Piezo-Elictric crystals
  • Grows and shrinks depending on the voltage run through it
  • Running an alternating current through it causes it to vibrate at a high speed and to produce an ultrasound wave
  • Sound is then reflected back to the PE crystals converting sound into electrical energy and then to photo energy
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2
Q

Doppler Waveform/effect - (siren e.g.) (5)

A
  • Doppler effect-the shift between emitted and observed frequency of sound
  • Velocity and Angle
  • Pulsed Doppler pulsed echo system
  • defines the rate which data is collected

Blood vessels have blood flowing + pressure = that is picked up
in an artery can pick up directions and sound waves are being reflected by RBC’s = pick it up = doppler waveform

  • Light moving away—red
  • Light moving towards– blue
  • Blood cells – scatter—RBC
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3
Q

Imaging in Normal menstrual cycle (3)

A

Endo
ovarian
changes during menstrual cycle

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4
Q

Endometrial pattern

A

Endometrial thickness comparison pre and post ovulation (Follicular and luteal) - there is a steady increase pre and then plateu of endo thickness + volume post ovul

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5
Q

After period

A

shortly after menstruation the endometrium appears as a thin white line

the follicles are small w/ < 8 mm in size and multipl

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6
Q

Mid follicular phase

A

the endometrium becomes thicker and manifests a “triple-layer” appearance

there is a dominant follicle ahead of the other follicles

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7
Q

Periovulatory phase

A

the day before ovulation the endometrium still has a “triple-layer” appearance but there is a thick white line surrounding it; this probably reflects some
progesterone production from the dominant follicle

Follicle is about 17-23 mm in size

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8
Q

luteal phase

A

endometrium is thick and homogenously hyperechoic (white)

Corpus luteum cystic or solid collapsed or full appearance with irregular edge and shadows w/ the the cyst = Raised dopplers are classical – roughly day 21

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9
Q

Resistance Index

A

A-B/Mean Difference of the highest and lowest value divided by the mean in one cardiac cycle

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10
Q

Pulsatility Index - gynae

A

A/B ratio indicates peripheral resistance

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11
Q

RI absent or reversal - foetal

A

Increase peripheral resistance causes diminution and then loss of blood
flow

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12
Q

3D AND 4D (4)

A
  • Coronal plane
  • Volume for review
  • TUI Like MRI
  • SONOAVC

1D - still image
2D - still image in motion
3D - static but from all angles
4D - all angles in motion

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13
Q

Gynaecology pathology looked at (3)

A
  • Uterus
  • Adnexa mainly fallopian tubes
  • Ovaries
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14
Q

What in the uterus is looked at? (4)

A
  • Polyp - small soft growth in the lining
  • Fibroids
  • Uterine malformation
  • Location of pregnancy
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15
Q

What is Slime inducing sonography (SIS) + Hycosy Catheter used for? (3)

A

picking up polyps - twist it and take it off

1) put catheter in uterus
2) put h2o in cavity = expansion of uterus
3) if polyp present - will be seen very easily

so seen by routine scans or SIS (hycosy checks the tubes)

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16
Q

What may be a presentation of a polyp - preg + non preg? (4)

A

preg:
miscarriages

non-preg:
spotting
bleeding

or asymp for both

17
Q

Polyp classification (3)

A

Type 0– fibroid polyp - completely in the cavity

Type 1 – Less than 50% within the myometrium (half the cavity)

Type 2 – more than 50% within the myometrium (<half the cavity)

18
Q

Uterine Malformations (4)

A

two halves of foetus that comes together to join - middle bit dissolves = uterus forms body + cervix

  • Arcuate uterus - in the past called thsi ( heart shaped)
  • bicornuate uterus - if they remain separate
  • uterine septum - if they join + middle doesn’t dissolve
  • Unicornuate uterus
19
Q

Early pregnancy Assessment - TVS (when there is a complication) (4)

A

Gestational sac and CRL - ectopic in uterine tubes
Visible cardiac activity
‘Bagel Sign’ (no foetus in it, just placenta + sac)
Inhomogeneous Mass ‘Blob Sign’ ( same thing - looks like a blob)

20
Q

Cervical Ectopic Pregnancy (2)

A

5/6 (83%) successfully treated with methotrexate
-single dose
-multiple dose
-intra-amniotic

*1 case then successfully treated with intra-amniotic KC

21
Q

LSCS Scar Ectopic Pregnancy (2)

A

ectopic in the c section scar

  • Series of 18 ectopics within
  • 71% (5/7) treated successfully with local Methotrexate ± KCl
22
Q

Cornual Ectopic Pregnancy (3)

A

starts in fallopian tube + in teh muscle of teh uterus

*20 interstitial pregnancies

*17 treated with single dose Methotrexate

*94 % success (16/17)

23
Q

What is a heterotopic pregnancy?

A

one in uterus
+
one in fallopian tube

1/10000 - very rare - slightly more common because of IVF

24
Q

when do you use Surgical Management in pregnancy? (6)

A
  • Pain
  • Haemodynamically unstable
  • High hCG
  • Viable ectopic pregnancy
  • Large ectopic mass
  • Haemoperitoneum
25
Q

Transvaginal Ultrasound (2)

A
  • Double thickness measurement of both endometrial surfaces at the thickest point in the mid-sagittal view - shouldn’t happen post-menopause because of oestrogen
  • If fluid present: layers individually measured and summated
26
Q

endo thickness + cancer

A

A meta-analysis of 85 published studies that included 5892 women showed that an endometrial thickness of greater than 5 mm identified 96% of endometrial cancer.

27
Q

When should Sonohysterography be used?

A

Should used when an endometrial echo is not well visualized or is not thin and distinct

28
Q

Ovarian pathology (5)

A
  • Endometriosis (bleeding elsewhere due to endometriosis @ other locations and cyst forms - endo. cyst) - chocolate cyst
  • Dermoid cyst (has hair, bone, teeth etc - most common benign cyst in reproductive age)
  • Polycyctic ovaries (not cyst - it is multiple follicles)
  • Cystadenoma (cyst with fluid - benign)
  • Mucinous cyst (cyst with unclear fluid)
29
Q

Clinical applications of ultrasounds (+ART) (6)

A
  • Assessment of Uterus and ovaries
  • Assessment of uterine cavity
  • Tubal patency – hycosy
  • Follicle growth
  • Egg retrieval
  • Embryo transfer

Science of Repro (32 decks)

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