Radiology Flashcards
What is the most common imaging used in gynaecology?
Ultrasound
Is there ionising radiation with ultrasound?
No
What are the 2 main ultrasound techniques used in gynaecology?
Transvaginal
Transabdominal
What should be carried out prior to transabdominal ultrasound?
Abdominal examination
A patient’s bladder should be voided prior to transabdominal ultrasound. True/False?
False
Bladder must be full! Acts as an acoustic window and displaces bowel loops to improve scan
What are some of the disadvantages of transabdominal ultrasound?
Difficult to obtain good image in obese patients or if gaseous distention of bowels
Difficult to reproduce same picture every time
Operator-dependent
What kind of ultrasound is used to assess flow through vasculature?
Doppler
Why is transvaginal ultrasound even done?
Probe can get closer to pelvic organs
A patient’s bladder should be voided prior to transvaginal ultrasound. True/False?
True
What are some of the disadvantages of transvaginal ultrasound?
More invasive
Not suitable for those not sexually active
May not depict full scale of any problems e.g large pelvic masses
When is CT typically used in gynaecology?
2nd line following US in those with abdominal pain
Post-surgical complications
Staging of cancer
What is the main disadvantage of CT, particularly in gynaecology?
High dose of ionising radiation, of which a significant amount is delivered to ovaries
Does MRI involve ionising radiation?
No
What is MRI useful for?
Depicting composition of organs and soft tissue masses (fluid, fat, blood etc.)
When is MRI typically used in gynaecology?
Cancer staging (esp cervical)
Evaluation of masses where diagnosis uncertain
Evaluation of subfertility
How does endometriosis differ between T1 and T2 -weighted MRI scans?
Blood and haemoglobin degradation products looks white on T1, grey on T2
What is hysterosalpingography (HSG)?
X-ray screening procedure that assess tubal patency of fallopian tube in infertility
Which is better for assessing staging and spread of cancer - MRI or CT?
MRI for staging (TNM)
CT for spread (nodes and distant mets)
What is a characteristic feature on US of a normal uterus?
White line of endometrium
What is a characteristic feature on US of normal ovaries?
Black dots in ovaries
List contraindications of MRI
Claustrophobia Severe obesity Pacemakers Metal heart valves Nerve stimulators Cochlear implants
Dermoid cysts or ovarian teratomas are difficult to see on US. Why?
They are composed of a mix of tissues, mostly fat, which is better seen on MRI or CT
Ovarian cancer typically disseminates via what type of spread?
Peritoneal spread
How is ovarian cancer initially diagnosed?
US as it shows ovarian masses
Cervical cancer typically disseminates via what type of spread?
Parametrium spread (usually into vagina and adjacent organs; rectum, ureters, bladder and regional nodes)
Which regional lymph nodes does metastatic cervical cancer spread to?
Obturator nodes
Internal iliac nodes
How is endometrial cancer initially diagnosed?
Transvaginal US for abnormal thickened endometrium in PMB
