Radiology

Question 1

What is the most common imaging used in gynaecology?

Answer 1

Ultrasound

Question 2

Is there ionising radiation with ultrasound?

Answer 2

No

Question 3

What are the 2 main ultrasound techniques used in gynaecology?

Answer 3

Transvaginal

Transabdominal

Question 4

What should be carried out prior to transabdominal ultrasound?

Answer 4

Abdominal examination

Question 5

A patient’s bladder should be voided prior to transabdominal ultrasound. True/False?

Answer 5

False

Bladder must be full! Acts as an acoustic window and displaces bowel loops to improve scan

Question 6

What are some of the disadvantages of transabdominal ultrasound?

Answer 6

Difficult to obtain good image in obese patients or if gaseous distention of bowels
Difficult to reproduce same picture every time
Operator-dependent

Question 7

What kind of ultrasound is used to assess flow through vasculature?

Answer 7

Doppler

Question 8

Why is transvaginal ultrasound even done?

Answer 8

Probe can get closer to pelvic organs

Question 9

A patient’s bladder should be voided prior to transvaginal ultrasound. True/False?

Answer 9

True

Question 10

What are some of the disadvantages of transvaginal ultrasound?

Answer 10

More invasive
Not suitable for those not sexually active
May not depict full scale of any problems e.g large pelvic masses

Question 11

When is CT typically used in gynaecology?

Answer 11

2nd line following US in those with abdominal pain
Post-surgical complications
Staging of cancer

Question 12

What is the main disadvantage of CT, particularly in gynaecology?

Answer 12

High dose of ionising radiation, of which a significant amount is delivered to ovaries

Question 13

Does MRI involve ionising radiation?

Answer 13

No

Question 14

What is MRI useful for?

Answer 14

Depicting composition of organs and soft tissue masses (fluid, fat, blood etc.)

Question 15

When is MRI typically used in gynaecology?

Answer 15

Cancer staging (esp cervical)
Evaluation of masses where diagnosis uncertain
Evaluation of subfertility

Question 16

How does endometriosis differ between T1 and T2 -weighted MRI scans?

Answer 16

Blood and haemoglobin degradation products looks white on T1, grey on T2

Question 17

What is hysterosalpingography (HSG)?

Answer 17

X-ray screening procedure that assess tubal patency of fallopian tube in infertility

Question 18

Which is better for assessing staging and spread of cancer - MRI or CT?

Answer 18

MRI for staging (TNM)

CT for spread (nodes and distant mets)

Question 19

What is a characteristic feature on US of a normal uterus?

Answer 19

White line of endometrium

Question 20

What is a characteristic feature on US of normal ovaries?

Answer 20

Black dots in ovaries

Question 21

List contraindications of MRI

Answer 21

Claustrophobia
Severe obesity
Pacemakers
Metal heart valves
Nerve stimulators
Cochlear implants

Question 22

Dermoid cysts or ovarian teratomas are difficult to see on US. Why?

Answer 22

They are composed of a mix of tissues, mostly fat, which is better seen on MRI or CT

Question 23

Ovarian cancer typically disseminates via what type of spread?

Answer 23

Peritoneal spread

Question 24

How is ovarian cancer initially diagnosed?

Answer 24

US as it shows ovarian masses

Question 25

Cervical cancer typically disseminates via what type of spread?

Answer 25

Parametrium spread (usually into vagina and adjacent organs; rectum, ureters, bladder and regional nodes)

Question 26

Which regional lymph nodes does metastatic cervical cancer spread to?

Answer 26

Obturator nodes

Internal iliac nodes

Question 27

How is endometrial cancer initially diagnosed?

Answer 27

Transvaginal US for abnormal thickened endometrium in PMB