Usually try to perform both transabdominal and transvaginal ultrasound
gold standard for what
In a post-menopausal female, the endometrial stripe should NOT exceed 5 mm. The only exception is if the post-menopausal patient is on hormone replacement therapy (HRT).
The width of the endometrial stripe can vary greatly, depending on the phase of the patient’s menstrual cycle.
The endometrial stripe CAN exceed 10 mm during the secretory phase of the patient’s menstrual cycle. That is why it is important that we ask what the last day of the patient’s previous menstrual cycle was when or before we perform the scan.
The normal endometrial stripe on ultrasound is bright (echogenic) and homogenous.
Describe a normal endometrial stripe?
in premenopausal women what mm
what about post
this is normal the cyst got left behind.
common to see in women of child bearing age
• Good for staging endometrial or ovarian carcinoma.
MRI pelvis used for staging or to look for
cost more money harder to get into
just reserved for those who can’t get an ultrasound
otherwise use ultrasound for pelivs
T scan may detect large masses in the uterus or ovaries, but is much less sensitive than the other modalities (Hysterosalpingography, Ultrasound, MRI).
** hard to see ovaries hard to see endometrium just good for really large masses or super large cysts that you can’t get on ultrasound**
***** Ultrasound(goldstanderd)>>>>MRI(fibroids, staging, cancer>>>>CT(for super large masses, large ovarian cysts etc)*****
contrast should spilling into the peritonal cavity
used to evaluate fertility
there should be constrast spilling if you don’t see this fallopian tubes closed off and infertility problems.
looks at what using contrast
used to evaluate what
**this is perminant it will permantly
scar the fallopian tube
so perminant infertility
*** must know this picture its high yeild
female also looks abrnoma b/c
is hetergenous endometrial stripe
(1.21cm X 10= 12mm)
again the endometrial stripe
How does it look like on MRI?
How does it look like on MRI
• > 5 cysts of > 5 mm. Cysts usually peripheral
bot ovaries are inovled
you see a bunch of cysts
greater than 5 cysts point to
Affected ovary large and hypoechoic (dark) due to edema
• Absent flow to ovary on Doppler
decreased blood flow to ovary
if no flow to ovary on doppler then points to
(** dopplar ultrasound needed for diagnosis of ovarian torsion).
– about how many cysts must you see to conclude this (ie what is the criteria)?
b/l or U/l ovarian involvement
what will you see on doppler
what are 2 common things you will see on
CT MRI (notice that you aren’t using ultrasound b/c dealing with carcinoma).
• May see thickening of endometrium. Gas in endometrium is diagnosti
what will you see on dryosalpinx
what about endometrium
If the fetal heart beat is not SEEN by transvaginal ultrasound in an embryo by 7 weeks gestational age or with crown-rump length (CRL) > 5mm, it is diagnostic of intrauterine embryonic demise
Which of the following statements is TRUE regarding intrauterine fetal demise.
Intrauterine fetal demise may be confidently diagnosed if the fetal heartbeat is not seen with transvaginal ultrasound by 7 wks. Gestational age (GA) or with a crown-rump length (CRL) > 5 mm
Fetal Demise true statement
NOT determined via ONLY CROWN RUMP:
The first day of the patient’s last menstrual period.
Consulting the patient’s ovulation diary.
Biometric measurements after 14 weeks
Uterine fundal height at 20 weeks
– Uterus may be normal or may be thickening of endometrium. Can see “pseudosac”.
– Free fluid (blood) in cul-de-sac
– Complex mass in adnexa, 95% chance of ectopic; Mass w/ “ring sign”, 97% chance; cyst in adnexa < 10% chance
what will be seen in transvaginal ultrasound
While we can often see prostate cancer with transrectal ultrasound (TRUS), studies have shown no improvement in the detection of prostate carcinoma when the sampling is done with TRUS over random sampling. The usefulness of TRUS with prostate biopsy is to ensure that all zones of the prostate are biopsied.
CT is not a good screening examination for prostate carcinoma metastases. Nuclear medicine bone scan is even more sensitive than CT scan and is much less expensive and gives a lower radiation dose than a head-to-toe CT scan.
what is it used for?
Orphan slide CT good for screening prostate carcinoma?
Best used for staging
• Better for imaging benign prostate hypertrophy than TRUS
MRI is very good for the detection of prostate carcinoma, but it is also very good for seeing BPH. In fact, MRI is the best study we have for the evaluation of BPH.
*** for male genitalia prostate use MRI and other areas of mean reproduction use***
CT and chest x-ray may be used to follow pulmonary metastases.
**use Ultrasound all thing testicular or scrotum**
what imaging modality should be used to detect it?
seen in what age group
Hydrocele and varicocele
The fundus of the uterus most commonly lies on top of the urinary bladder.
MRI is very good for the evaluation of uterine fibroids
Most common presentation of uterus is pelvis anteversion
what is the most common presentation of the uterus
Masses within the testicle are usually MALIGNANT. Masses within the scrotum, but not within the testicle, are usually BENIGN
There must be a complete lack of flow within a testicle to diagnose testicular torsion.
Epididymo-orchitis is diagnosed by INCREASED flow within the testicle and/or epididymis.
Nuclear medicine testicular imaging is an archaic study from before Doppler ultrasound was available and has no place in our diagnostic armamentarium.