Lecture 20 - Repro Imaging

Question 1

What imaging techniques are used to investigate repro pathology ?

Answer 1

Mostly ultrasound
MRI
Fluoroscopy
CT - staging

Question 2

Ultrasound scan benefits

Answer 2

Quick
Easy
Safe
No radiation as the repro system has highly active cell division

Question 3

Types of ultrasound

Answer 3

Transvaginal- better view of ovaries as closer to cervix

Transabdominal

Question 4

Hysterosalpingography

Answer 4

Radiolucent due used as USS contrast

Used to view stenosis and defects in the Fallopian tubes

Question 5

Male USS use

Answer 5

USS of prostate to see BPH or prostatic cancer (biopsy needed)

Question 6

Follicular cyst

Answer 6

Dominant Graafian follicle sometimes fails to ovulate and does not involute
Becomes larger than 3cm = follicular cyst
Usually 3 - 8 cm but may be bigger
Resolves spontaneously on follow up

USS: simple unilocular (one cavity) and anechoic (black)with a thin smooth wall

Question 7

Corpus luteal cyst

Answer 7

Corpus luteum that has sealed and filled with fluid or blood
Ring of fire appearance on circular Doppler
Women on birth control won’t form corpus luteum as prevention of ovulation therefore low risk
Fertility drugs that induce ovulation will increase the risk of getting a corpus luteum cyst

Question 8

Haemorrhagic cysts

Answer 8

Bleeding into the cyst therefore great on USS

Should resolve

Question 9

Hyperandrogenic anovulation

Answer 9

Chronic anovulation or oligo-ovulation due to androgen excess
Polycystic ovarian syndrome morphology on ultrasounds
- small cysts in ovaries

Question 10

Mature cystic ovarian teratoma

Answer 10

Encapsulated tumours with mature tissue or organ components
Contain well differentiated derivatives from at least 2 of the 3 germ layers
Contain mature skin with hair follicles and sweat glands

Question 11

Ovarian hyperstimulation

Answer 11

Hormonal overstimulation by Beta HCG
Bilateral
Can occur in gestational trophoblastic disease, PCOS or patients receiving hormonal therapy

Question 12

PID

Answer 12

Ascending infection that has spread form the vagina or cervix to the:

• endometrium - endometritis
• Fallopian tubes - salpingitis
• Other structures like the ovaries - ovarian assessed
• peritoneal cavity - peritonitis

Question 13

Malignant ovarian lesion investigation

Answer 13

USS and MRI

Blood markers - CA125

Cancer staging - contrast enhanced CT

Question 14

High risk patients for ovarian cancer

Answer 14

Postmenopausal 
Family history 
BRCA 1/2 carriers 
HNPCC - hereditary nonpolyposis colorectal cancer 
Ashkenazi descent