Trans - Radiology of the Pelvis Flashcards
Primary modality in imaging pelvic organs
Ultrasound
Used to diagnose congenital abnormalities and mechanical causes of infertility
HSG
Transducer type with greater spatial resolution but limited penetration
High frequency
High frequency transducers are used for
endoluminal applications
Endocavitary transducers are used for:
transabdominal and transvaginal ultrasound
Transducer used for small parts and children
linear transducer
Transducer type with greater spatial penetration but poor resolution
Low frequency
Transducer used for abdominal, pelvic, obstetric ultrasound
convex transducer
Swinging the transducer left to right produces:
sagittal image
Swinging the transducer up and down produces
transverse image
shape of prepubertal infantile uterus
cigar-shaped
shape of postpubertal uterus
pear-shaped
difference of anteverted/retroverted from anteflexed/retroflexed
- verted - pointing in anterior (ante) or posterior (retro) directions
- flexed - folded anteriorly (ante) or posteriorly (retro)
for imaging the uterus, how is the ultrasound done so that it is clearer
transvaginal approach
an ovarian physiologic cyst resolves in
10 weeks
how to differentiate an endometrioma from a hemorrhagic cyst in the ovary
endometrioma - does not resolve in 2 weeks
hemorrhagic cyst - resolves in 2 weeks
adnexa are composed of:
Ovaries
Fallopian tube
Broad ligament
Ovarian and uterine vessels
dense fibrous tissue covering the testis
tunica albuginea
invagination of tunica albuginea produces
mediastinal testes
Transverse view of both testes
Dolly Parton view
When the uterus is in the secretory stage, it is uniformly _________
Echogenic (light gray to white)
Trilaminar endometrium seen in pelvic imaging is indicative of what phase of the menstrual cycle?
Proliferative phase
These kinds of follicles are seen in postmenoposal ovary
No follicles are seen in postmenoposal ovaries
Focal lesions in the ovary; cysts with thick walls and variable internal echoes due to hemorrhage
Endometrioma
Condition resulting from minimal fluid in sac, manifesting as anechoic fluid surrounding the testicle
Hydrocoele
Condition resulting in increased vascularity of epididymis and testes, producing hyperechoic ultrasound images
Acute epididymo-orchitis
Acute epididymo-orchitis is (hypoechoic/hyperechoic) while hydrocoele is (hypoechoic/hyperechoic)
Acute epididymo-orchitis – hyperechoic
Hydrocoele – hypoechoic
View best used to compare testes and detect focal abnormalities
Dolly Parton View (transverse view of both testes)
A patient with benign prostatic hypertrophy will manifest the following findings on a transabdominal ultrasound of prostate and bladder, EXCEPT
a. enlarged central portion of prostate
b. enlarged peripheral portion of prostate
c. increased heterogeneity of prostatic image
B
A convoluted, hypoechoic structure at the base of the prostate and urinary bladder
Seminal vesicle
In a T2 MRI, a urine-distended bladder is colored ____
White
Given a CT Scan, arrange the following structures in order of decreasing Hounsfield unit index: Fluid, air, bone, soft tissue
Air > Bone > Soft Tissue > Fluid
This is the linear transformation of the original transformation coefficiant measurement into one in which the radiodensity of distilled water at STP is defined as zero
Hounsfield units (HU)
An advantage of this imaging procedure is its outstanding soft tissue contrast resolution.
MRI
A normal uterus appearing in a T-2 weighed MRI shows that the endometrium has (a)___ intensity, the inner myometrium has (b)___ intensity and outer myometrium has (c)___ intensity.
a. Low
b. High
c. Intermediate
Contrast spilling into the peritoneum in hysterosalpingography indicate that _______
Fallopian tubes are patent (contrast material spills out of the fimbriated ends into the peritoneal cavity)
A normal hysterosalpingography will show:
contrast fluid spilling into the peritoneal cavity
Procedure used to visualize uterine canal and fallopian tubes, done under fluoroscopy
Hysterosalpingography
medium with HU <10
fluid
medium with HU < 1000
air
medium with HU > 400
bone
medium with HU from 40-80
soft tissue
When one wall of the bladder seems thicker than the other in imagine, the likely abnormality is
Cystitis
