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RCPSC > Gynae imaging > Flashcards

Gynae imaging Flashcards

1
Q

O-RADS Score 1 description

A

Normal ovary
- follicle defined as simple cyst =<3cm
- corpus luteum =<3cm

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2
Q

O-RADS Score 2 description

A

Almost certainly benign [<1%]
- simple cyst
- classic benign lesions
- non-simple unilocaular cyst, smooth inner margin

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3
Q

O-RADS Score 3 description

A

Low risk Malignancy [1-<10%]

  • unilocular cyst (simple or non-simple >=10cm)
  • typical dermoid cysts, endometriosis, hemorrhagic cysts >=10cm
  • unilocular cyst with irregular inner wall, any size
  • multilocular cyst with smooth inner walls/septations, <10cm and color score 1-3
  • solid lesion with smooth out contour, any size, CS=1
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4
Q

O-RADS score 4 risk

A

Intermediate risk [10-50%]

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5
Q

O-RADS score 5 description

A

High risk [>=50%]

  • unilocular cyst >=4 papillary projections
  • multilocular cyst with solid component + CS=3-4
  • solid lesion with smooth outer contour, CS = 4
  • solid lesion with irregular outer contour
  • ascites and/or peritoneal nodules
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6
Q

O-RADS 0

A

Incomplete evaluation - repeat study or alternate study

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7
Q

O-RADS 1 Management

A

None

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8
Q

O-RADS 5 management

A

Gyn-oncologist

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9
Q

O-RADS 4 management

A

US specialist or MRI
Management by gynaecologist with gyn-on consultation or solely by gyn-onc

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10
Q

O-RADS 3 management

A

US specialist or MRI
Management by gynecologist

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11
Q

Simple Cyst management Pre-menopausal [o-rads 2]

A

none unless 5-10cm size, then follow-up in 8-12 weeks

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12
Q

Simple cyst management post-menopausal [O-RADS2]

A

any cyst 3-10cm:
follow-up in one year

ideally showing stability or decrease in size
Consideration of annual follow-up of up to 5 years if stable

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13
Q

Cyst with Reticular pattern,
Retracting clot (avascular echogenic component with angular, straight, or concave margins)

A

Typical hemorrhagic cyst
O-RADS2

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14
Q

Cyst with
- hyperechoic components and acoustic shadowing
- hyperechoic lines and dots
- floating echogenic spherical structures

A

Typical dermoid cyst, <10cm, O-RADS2

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15
Q

Cyst with ground glass/homogenous low-level echoes

A

Typical endometrioma, <10cm
O-RADS2

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16
Q

Simple cyst separate from the ovary, typically moved independently of ovary when pressure is applied by the transducer

A

Simple paraovarian cyst/any size
O-RADS2

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17
Q

Cyst follows the contour of the adjacent pelvic organs , does not exert mass effect and typically contains separations
- ovary either at margin or suspended within lesion

A

Typical peritoneal inclusion cyst, any size,
O-RADS2

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18
Q

Cyst with
- incomplete septation
- tubular
- endosalpingeal folds

A

Typical hydrosalpinx, any size O-RADS2

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19
Q

Management of hemorrhagic cyst, pre-menopausal

A

nothing if =<5cm

followup in 8-12 weeks if 5-10cm

If persists or enlarges, referral to US specialist, gynaecologist or MRI

20
Q

Management of hemorrhagic cyst, post-menopausal

A

US specialist, gynaecologist or MRI any size

21
Q

Management of typical dermoid cyst or endometrioma <10cm, premenopausal

A

optional initial f/u in 8-12 weeks based on confidence of diagnosis.

if not removed surgically, annual USS

US specialist or MRI if any enlargement, changing morphology, or new vascular component

22
Q

management of typical dermoid or endometrioma, <10cm, postmenopausal

A

US specialist, gynaecologist, or MRI.

Annual US if not removed
MRI if enlargement

23
Q

management of simple paraovarian cyst postmenopausal

A

optional single follow-up study in 1 year

24
Q

management of non-simple, unilocular cyst, with smooth inner margins

pre and post MP

A

PreMP
f/u if 3-10cm in 8-12 weeks.

Post-MP
<3cm, followup in 1 year,
>3cm-10cm, US specialist or MRI

25
Q

Unilocular cyst, simple or non-simple, >=10cm - category

A

O-RADS3

26
Q

typical dermoid cyst, endometrioma, or hemorrhagic cysts >=10cm

A

O-RADS3

27
Q

unilocular cyst, with irregular inner wall (<3mm height), any size

A

O-RADS3

28
Q

multilocular cyst with smooth inner walls/septations, <10cm, CS1-3

A

O-RADS3

29
Q

solid lesion with smooth outer contour, any size, CS =1

A

O-RADS3

30
Q

Multilocular cyst, no solid component, >=10cm, smooth inner wall, and CS 1-3

A

O-RADS4

31
Q

multilocular cyst w/o solid components, smooth inner wall, any size by CS=4

A

O-RADS4

32
Q

Multilocular cyst w/o solid components, irregular inner wall +/- irregular separation, any size, CS=any

A

O-RADS4

33
Q

Unilocular cyst with solid components (1-2 papillary projections), any size, CS= any

A

O-RADS4

34
Q

Multilocular cyst with solid component, any size, CS=1-2

A

O-RADS4

35
Q

Solid lesion, smooth outer contour, any size, CS=2-3

A

O-RADS4

36
Q

Unilocular cyst, 4 or more papillary projections, any size, CS=any

A

O-RADS5

37
Q

multilocular cyst with solid component, any size, CS = 3-4

A

O-RADS5

38
Q

solid lesion with smooth outer contour, any size, CS = 4

A

O-RADS5

39
Q

solid lesion with irregular outer contour, any size, CS= any

A

O-RADS5

40
Q

ascites and /or peritoneal nodules - classification ?

A

O-RADS5

41
Q

simple cyst definition

A

subset of unilocular cyst with:
- smooth, thin wall,
- acoustic enhancement, and
- no internal elements (anechoic)

42
Q

papillary projection or nodule height

A

> =3mm

43
Q

thick walled cyst <3cm, may have crenelated inner margins, internal echoes, and intense peripheral doppler flow

A

corpus luteum

44
Q

imaging modality of choice for suspected adnexal torsion

A

USS with and without CF doppler

45
Q

most frequent findings on USS for ovarian torsion

A

enlarged ovaries and absence of flow

RCPSC (17 decks)

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