Diagnostic radiology: women imaging Flashcards
(33 cards)
What are the 2 basic views of mammography?
Craniocaudal (CC)
Mediolateral oblique (MLO)
What is the indication of breast US elastography?
What is the use of breast MRI?
- High risk screening
- Patient with breast augmentation
- Detect occult cancer and evaluate disease extent
What features are observed for in mammogram for malignancy?
Tumour (mass, density)
- poorly circumscribed, irregular, spiculated, dense
Microcalcification
- irregular, pleomorphic sizes and density, linear,
clustered Retraction (distortion)
What are USG findings of breast malignancy?
- Hypoechoic
- Irregular mass
- Vascularity
What are USG findings of breast mass (benign)?
- Round or oval
- No vascularity
- Anechoic (breast cyst)
- Hypoechoic (fibroadenoma)
Benefits and disadv of transvaginal/transabd ultrasound?
For pelvic pain what is first line imaging and other possible imagings done?
US: initial imaging investigation
MRI: useful in identifying gyne causes e.g. endometriosis, adenomyosis
CT: for non gynaecological cause
What imaging for pre-menopausal abnormal vaginal bleeding?
- US: imaging of choice to exclude the presence of leiomyoma (fibroid), endometrial or adnexal abnormality
- If bleeding persists, gynaecological referral for hysteroscopic examination should be considered
What imaging for post-menopausal abnormal vaginal bleeding?
- TVUS: recommended to assess endometrial thickness
- Endometrial thickening ≥5 mm or abnormal morphology should be investigated by biopsy
What is sequence of imaging for suspected pelvic mass?
- US: recommended as initial evaluation to confirm the presence of pelvic mass and likely origin.
- MRI: indeterminate pelvic mass on US and for further characterisation.
- CT: reserved for staging pelvic mass with high probability of malignancy (skip MRI if there is ascites and other suggestive signs).
What is the imaging choices for gynecological cancers?
- US: often the initial evaluation to confirm the presence of pelvic malignancy
- MRI: local pelvic staging
- CT (or PET/CT): extra-pelvic staging for metastastic screening
What is the imaging for infertility in woman?
- US: assess pelvic congenital anomaly or pathology
- Hysterosalpingography (HSG): fluoroscopic evaluation of uterine cavity and fallopian tubes, assess tubal patency
- MRI: structural assessment if US suggests abnormality
What are the different mulleriaen duct anomalies?
A. Unicornuate uterus (20%)
- Single uterine horn; may have rudimentary horn
B. Uterus didelphys (5%)
- 2 separate, non-communicating horns
- 2 cervices
C. Bicornuate uterus (10%)
- Concave or heart-shaped external contour
- 2 horns with variable fusion
D. Septate uterus (55%)
- Normal external contour
- Septum may extend for variable lengths
- Complete (to external os) or partial
Uterus didelphys:
- 2 separate, non-communicating horns, 2 cervices
- Assess for concomitant renal anomalies
Which is pre menopause and post menopause?
MMG
* Skin thickening around nipple
Require tru-cut biopsy (molecular dx)
Breast
- 28-year old
- Recently given birth and breast-feeding
- 1-week history of painful right breast mass * Associated with fever
Differential Diagnosis?
Any imaging investigation that you wish to order?
Mastitis, breast abscess
USG
Don’t do mammogram in young lady (compressed by 2 planes will be painful in infective cause)
Painful breast mass with fever
- Heterogeneous, predominantly hypoechoic mass
- Fluid collection with thick wall
- Doppler: ↑ Peripheral vascularity
- Drainage can be arranged
- MMG not indicated in young woman with typical presentation
