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REPRO > Imaging in Obs > Flashcards

Imaging in Obs Flashcards

1
Q

Imaging methods?

A
  • USG: v. important in Gynae pts
  • CT
  • MRI
  • X-ray fluoroscopy (Hysterosalpingograms)
  • PET-CT
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2
Q

Indications for using radiology?

A
  • pelvic pain (chronic/acut)
  • pelvic masses
  • abnormal menstrual bleeding
  • post-menopausal bleeding )check for endometrial thickness)
  • invx of infertility (hysterosalpingograms—patency of tubes)
  • interventional radiology - fallopian tube (uterine art. embolisation/ fallopian tube recanalisation)
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3
Q

Pros of USG?

A
  • cheap
  • safe (no ionising radiation)
  • good def. of diff. pelvic organs
  • used adjunct to pelvic exam.
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4
Q

Where are medical imaging ivx stored?

A
  • on PACS
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5
Q

2 main USG techniques?

A
  • Transabdominal
  • Transvaginal (well tolerated)

—–start with the transabdominal and then transvaginal

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6
Q

Why scan the upper abdomen first?

A
  • ensure no hydronephrosis (better overview)
  • to check for ASCITEs
  • ensures pelvic abnormality is NOT secondary to upper abdom. pathology
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7
Q

Why must the pt come in with a full bladder?

A
  • urine-distended bladder acts as an acoustic window
  • —also displaces the gas-filled BOWEL loops out of the pelvis (as the gas scatter the USG beam and degrades the quality )
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8
Q

Adv. of Transabd. USG?

A

Safe
Readily available
No ionising radiation and therefore ideal for children and women of reproductive age

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9
Q

Placement of the scan vertically; gives a

A
  • sagittal view
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10
Q
  • Horizontal placement of the Transabd. USG?
A
  • horizontal views of the (like Ct)..?
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11
Q

Important landmark to note in transabd. USG?

A
  • external iliac vessels
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12
Q

Disadv. of transvaginal scan?

A
  • More invasive procedure
  • not for non-sexually active people
  • “the tip of the iceberg”
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13
Q

Normal appearance of the ovaries on the USG?

A
  • FOLLICLES can be seen of the ovaries
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14
Q

How does a rupture ovarian cyst appear as?

A
  • mixed acougenicity

- (black and white mixing; not distinct)

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15
Q

Indications of CT scan?

A
  • 2nd line for acute abdomen
  • to asses post-surgical complications (SBO/ adhesions/ abscesses)
  • staging of gynaecological malignancies (ovarian and endometrium)
  • to assess response to rx in pts after chemotherapy +/- radiotherapy
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16
Q

Advs of CT?

A

Quick
The entire chest abdomen and pelvis can be assessed on one scan
Modern multiple detector row (“multislice”) scanners produce very thin slices and images can be manipulated to produce coronal and sagittal reformats, as well as the axial source images

17
Q

Disadv. of CT

A
  • HIGH radiation (160 CXR)
  • not used in kids and those in reproduct. age
  • not optimal depiction of diff. pelvic organs
18
Q

How to confirm a dermoid cyst?

A
  • dermoid cyst = FAT within cyst (black color = fat on CT)
19
Q

How diff. is T1 and T2 in picking up various substances?

A

T2- BRIGHT with water

T1- bright with proteins and blood

20
Q

Adv of MRI?

A
  • safe in preg. pt except in 1st trimester
  • good forkids
  • excellent depiction of pelvic organs
  • idea of SOFT tissue masses (contains fat/fluid/blood?)
21
Q

Disadv. of MRI?

A
  • MRI not best for scanning the lungs
  • TIME-consumng
  • not best for those with claustrophobia
  • C./I in thos with metal implants
22
Q

USe of MRI?

A
  • Cancer staging
  • evaluation of adnexal masses and uterine masses
  • evaluation of pts with sub-fertility
  • suspected prolactinoma
23
Q

How to dx endometriosis?

A
  • diagnostic laproscopy
24
Q

Bright on T1?

A
  • —FAT

- - BUT dark on fat-supression sequences

25
Q

Hysterosalpingography

A
  • helps outline the uterine cavity
  • assessment of tubal patency
  • procedure done in 3-5mins
  • cervix is cannulated and RADIO-OPAQUE
26
Q

Medical imaging in cancer - significance?

A

A pre-treatment scan serves as a “baseline” study so that subsequent scans can be used to assess response to treatment (chemotherapy, radiotherapy etc)

27
Q

Dx of Ovarian cancer?

A
  • initial dx: made by USG

- staging by CT scanning

28
Q

Staging of cervical cancer- important to determine:

A
  • spread to parametrium
  • extension to VAGINA
  • infil. of adjacent organs
  • metastases to regional LNs
29
Q

MRI or CT for cancer scane (cervical)?

A
  • MRI is good for local pathology

- CT to check for metastases

30
Q

How to check for endometrial cancer?

A
  • transvaginal USG (look for THICKENED endometrium in post-menopausal women)
  • —MR scan to assess degree of myometrial invasion
  • –CT scanning for distant NODAL metastases and pulmonary metastases
31
Q

What should be noted with obese pts and scanning for endometrial cancer?

A

-can be large for the narrow bore of MR scanners

REPRO (55 decks)

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