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Flashcards in Imaging Deck (35):
1

What imaging methods are used in obs & gynae?

USS
CT
MRI
X-ray screning fluoroscopy e.g. hysterosalpimgograms (HSG)
Functional imaging (PET-CT)

2

What are indications for radiology?

Pelvic pain/masses
Abnormal menstrual bleeding
Post menopausal bleeding
Infertility
Fallopian tube recanulisation
Urinary artery embolism etc

3

What imaging technique is the most common, and why?

USS
Cheap
Safe
Can be used in clinic

4

What are the 2 main ultrasound techniques used?

Transabdominal
Transvaginal

5

Describe transabdominal USS

Scanning using a standard general abdominal US transducer

6

Describe transvaginal USS

Scanning using a dedicated endocavity high-frequency transucer

7

Why should you USS the upper abdomen briefly when doing an obs&gynae USS?

Check for hydronephrosis
Early ascites
CHeck the pelvic issue isn't secondary to a upper abdo pathology

8

Why must the patient have a full bladder?

The urine-distended bladder acts as an "acoustic window"
Displaces gas-filled loops of bowel out of the pelvis

9

What are the advantages of doing an USS?

Safe
Readily available
No ionising radiation

10

What are the disadvantages of an USS?

Difficult to obtain good images in obese patients and those with gaseous bowel distension
Operator dependant
Hard to produce same image every time so not good at assessing the response to cancer treatment

11

Describe the waves of a higher frequency

Shorter wavelengths
Better spatial resolution

12

What is bad about using a higher frequency?

Need to be closer target organ

13

What is needed for a transvaginal USS?

An empty bladder

14

What is an advantage of Transvaginal scanning?

Excellent depiction of the pelvic organs

15

What are some disadvantages of transvaginal screening?

More invasive
Not suitable for patients who have not been sexually active
May not depict the whole issue

16

When is a CT scan usually used?

2nd line to an USS when patient demonstrates pain

17

What can a CT be good for?

Assess post-surgical complications
Staging of malignancy
Assessing response to treatments

18

What are advantages of CT?

Quick
entire chest, abdo and pelvis can be seen in one scan
Multiple coronal and sagittal pics

19

What are some disadvantages of CT?

High radiation
Doesn't provide optimal depiction of different pelvic organs

20

What are advantages to MRI?

Provides an excellent depiction of pelvic organs
No ionising radiation
Can give info on soft tissue masses

21

What are disadvantages of MRI?

Time-consuming
Poor depiction of lung paranchyma
Not tolerated if patients have claustorphobia
Contra-indicated in patients with pacemakers, many artificial heart valves, nerve stimulators, cochlear implants etc.

22

When can MRI be useful in obs&gynae patients?

Cancer staging
Further evaluation and characterisation of adnexal and uterine masses
Sub-fertility evaluation
MRI of pituitary gland is performed in patients with suspected prolactinoma

23

What do endometriosis deposits contain?

Altered blood and haemoglobin degradation products

24

What type of scan is better to see endometriosis?

T1 sequences

25

What do dermoid cysts contain? (Ovarian teratomas)

Tissue derived from the ectoderm and fat

26

What is a Hysterosalpingogaphy (HSG)?

X-ray screening procedure
Assessment for tubal patency in infertility
Outline uterine cavity

27

How long does a HSG take?

3-5 mins

28

What is done in a HSG?

Cervix is cannulated and radioopaque contrast instilled to fill the uterine cavity

29

In cancer staging, what does TNM stand for?

Tumour
Nodes
Metastases

30

How does ovarian cancer disseminate?

peritoneal spread

31

What is important to find out regarding cervical cancer?

Spread to parametrium?
Extension into vagina?
infiltration of adjacent organs?
Metastases to regional lymph nodes?

32

What is best imaging for depicting local disease?

MRI (T2)

33

What is the best method for looking at endometrial cancer?

Transvaginal USS

34

What use to MRI and CT have in endometrial cancer?

MRI - assess degree of myometrial invasion
CT - Look for distant nodal metastases and pulmonary mets

35

What are many endometrial cancer patients?

Obese