RADIOLOGY 2029

Breasts

What structure is involved in the parenting stage of reproduction but not always included in the reproductive system classifications?

Android (wedge or heart; narrower), Gynecoid (oval; wider)

What are the shapes of the inlet of the male and female pelvis respectively?

Conjugate is greater than Transverse, Transverse is greater than Conjugate

What are the diameter differences between male and female pelvises?

Long narrow notch High rounded apex, Wide notch Blunt apex

What are the differences in the sacrosciatic notch between the male and female pelvises?

Narrow and long Curved inward, Wide and short Curved outward

What are the differences in the sacrum between male and female pelvises?

Sharp, Blunt

What are the shapes of the ischial spines in the male and female pelvises?

Narrow, Wide More obtuse

What are the pubic angles in the male and female pelvises?

Ischial spines

Which part of the pelvis is more prominent in males, aiding in muscle attachment?

X-ray, Ultrasonography, CT Scan, MRI

List four modalities used for imaging reproductive structures

Bone, Joint, Soft tissue outlines

What structures are visualized in a plain radiography of the pelvis?

Uterus, Ovaries, Fallopian tubes, Cervix, Vagina

List the female structures NOT directly visualized on plain x-rays

Testis, Epididymis, Vas deferens, Seminal vesicles, Prostate, Penis

List the male structures NOT directly visualized on plain x-rays

Fluoroscopic Studies

Which imaging technique uses x-rays to obtain real-time moving images of interior structures as dye is injected?

Hysterosalpingography

What is another name for a hysterogram?

Congenital anomalies of the female genital tract, mechanical causes of infertility

What can be diagnosed using Hysterosalpingography?

Cervix, Uterine cavity, Fallopian tubes, Peritoneal cavity

What structures are imaged in Hysterosalpingography?

Structural abnormalities, Skeletal shape, size, symmetry, contours, Abnormal calcifications or foreign bodies in soft tissues

What should you check for in a preliminary fluoroscopic image before contrast insertion?

Water-soluble iodine-containing contrast

What type of dye is injected in Hysterosalpingography?

Length, smooth contour or feathery pattern

What characteristics of the cervix should you look for in a Hysterosalpingogram?

Position, shape, wall contours, filling defects

What characteristics of the uterine cavity should you look for in a Hysterosalpingogram?

Intramural (1-25 mm diameter), Isthmus, Ampulla (widest 5-8 mm; longest 6-8 cm), Infundibulum

List the four parts of the fallopian tube

Unobstructed bilateral contrast spillage

What characteristic of the peritoneal cavity should you look for in a Hysterosalpingogram?

Hydrosalpinx

What is the buildup of fluid inside the fallopian tube due to blockage called?

Salpingitis isthmica nodosa

What is the presence of nodular outpouchings along the fallopian tube called?

Ovaries

Which of the following structures cannot be visualized in a hysterosalpingogram: Uterine cavity, Fallopian tubes, Ovaries, or Peritoneal cavity?

Ultrasonography

Which imaging modality is the imaging of choice for reproductive imaging?

Free from radiation, fast, sufficient for the depiction of normal and pathological anatomy

List the advantages of ultrasonography

Insufficient for tumor staging, insufficient for diagnosis of adnexal masses

List the disadvantages of ultrasonography

Uterus, Ovaries

What normal female structures are visualized using ultrasonography?

Prostate, Testes, Epididymis

What normal male structures are visualized using ultrasonography?

Curvilinear probe, endocavitary probe, and linear probe

What are the different probes used in ultrasonography?

Transabdominal

Which ultrasound approach uses a curvilinear probe?

Scrotal

Which ultrasound uses a linear probe?

Lower frequency

What kind of frequency does transabdominal ultrasound use?

Higher definition of pelvic structures

What does transvaginal ultrasound provide?

Higher frequency

What kind of frequency does transvaginal ultrasound use?

Myometrium

What is the uterus wall shown as on the sides of the endometrium in an ultrasound?

Hyperechoic line 1-4 mm

What does the endometrium appear as on days 1-4 of the menstrual cycle?

Hyperechoic line 5-7 mm

What does the endometrium appear as on days 5-13 (early proliferative stage) of the menstrual cycle?

Trilaminar appearance < 11 mm

What does the endometrium appear as on days 14-16 (late proliferative stage) of the menstrual cycle?

Thickened hyperechoic endometrium ≤ 16 mm

What does the endometrium appear as on days 16-28 (secretory phase) of the menstrual cycle?

What is the cut off value for pre-menopausal and post-menopausal ovaries respectively?

Dominant follicles

What kind of follicles are present during the early proliferative phase?

3 cm

How big can dominant follicles measure up to?

22 cc

What is the cutoff for an enlarged ovary?

Transrectal Ultrasound

What kind of ultrasound can be used to visualize the prostate gland in higher resolution?

MRI screening

What is an alternative to transrectal ultrasound when visualizing the prostate gland?

Prostatic calcifications

What is usually common in men as they age that may cause stress or urinary issues?

Transrectal ultrasound

How are seminal vesicles best visualized?

Sagittal and transverse views

What kind of views are used to visualize seminal vesicles?

High-frequency linear transducer

What kind of transducer is used to visualize the scrotum?

Testis, Pampiniform plexus, Vascular structures of the penis

During scrotal ultrasound, what structures are visualized?

Symmetry, position and echotexture

What is determined in a "Twins view" scrotal ultrasound?

Echogenic to isoechoic

What is the echogenic appearance of the testicles on a scrotal ultrasound?

Epididymal Head

What is located at the superior aspect of the testes?

Doppler

What is added to the ultrasound study to check if there is normal blood flow?

Testicular torsion

What is a common emergency at night that involves the cutoff of blood supply to the testis, usually happening in children?

Check if there is vascularity by using the doppler ultrasound

What is the first thing to do if there is a suspected case of testicular torsion?

Penile sonography

What kind of ultrasound is performed with the patient supine with the penis lying on the anterior abdominal wall?

Erectile failure or vasculogenic impotence due to poor arterial inflow or excessive venous leakage

What is penile doppler used to check for?

Corpora cavernosa, Corpus spongiosum

What structures are checked using Penile Doppler?

Plain radiography, Fluoroscopy, Ultrasonography, CT Scan

List 4 imaging modalities

Superior in depicting fat planes and adenopathy

What is the advantage of using CT Scans?

Poor soft-tissue contrast

What is the disadvantage of using CT Scans?

Uterus

Which female reproductive organ is usually homogenous with soft tissue density on an Axial CT scan?

Ovaries

Which female reproductive organs appear as oval soft tissue densities on an Axial CT scan?

Masses

What is assessed using a Sagittal CT scan of the uterus?

Retroverted, Anteverted

What are the two positions of the uterus?

Prostate gland

What structure is seen at the base of the bladder on a CT scan of the male pelvis?

Ultrasound

What is the first-line imaging for scrotal and testicular pathologies?

CT scan

What imaging modality can detect trauma, testicular cancer metastasis, and pelvic masses in the male pelvis?

Transvaginal ultrasound

What imaging modality provides a detailed view of the uterus and ovaries, making it the preferred imaging modality for pelvic evaluation in non-pregnant females?

Transabdominal ultrasound

What imaging modality is used to assess larger pelvic masses and monitor pregnancy?

CT scan

What imaging modality of the female reproductive system is used for cancer staging and evaluating acute pelvic pain when ultrasound is inconclusive?

Scrotal ultrasound

What imaging modality should show bilateral testicles as relatively echogenic to isoechoic, homogenous, and contained within each scrotal sac?

Penile Doppler ultrasound

What imaging modality can assess erectile dysfunction and vasculogenic impotence?

Axial CT

What imaging modality of the female pelvis can visualize the homogeneous uterus and paired ovaries?

Sagittal CT

What imaging modality offers a better view of uterine position and masses compared to axial and transverse views?

CT

What imaging modality of the prostate is possible but cannot delineate zonal anatomy, unlike transrectal ultrasound?

Direct multiplanar imaging, more detailed images of soft tissue organs, safe for pregnant patients

What are the advantages of using MRI?

High cost, Availability

What are the limitations of using MRI?

Sagittal plane

What plane is ideal for demonstrating the uterine zonal anatomy and vaginal anatomy in MRI?

Glandular tissue of the endometrium

What does the inner high signal intensity stripe represent in MRI of the female pelvis?

Junctional zone

What is the very low signal intensity deeper myometrium called in MRI of the female pelvis?

Central gland

Which zone of the prostate displays generally lower signal intensity than the peripheral gland?

Peripheral gland

Which zone of the prostate displays higher signal on T2 weighted images because of the presence of generally larger and more numerous glandular lumen than that of the fibromuscular tissue of the central gland?

Anterior Fibromuscular Stroma

Which zone of the prostate is a low-signal intensity structure occupying the anterior edge of the prostate?

Pelvimetry

What is the radiographic assessment of the female bony pelvis called?

Inlet, Midplane, Outlet

What are the three anatomical cavities measured by pelvimetry?

Inlet, Midpelvis, Outlet

What are the landmarks used in the Colcher-Sussman Method?

Obstetric ultrasound

What is the preferred method for monitoring pregnant women and their unborn babies?

2-5 MHz, 36-75 MHz

What frequency is used for fetal imaging and pelvic imaging respectively?

Gestational sac

What is the first sign of pregnancy visible on transvaginal ultrasound?

5 weeks age of gestation (AOG)

When can the Gestational sac be seen?

Yolk sac

What can be seen at 55 weeks AOG?

Fetal pole/embryo

What can be seen at 6 weeks AOG?

Crown Rump Length (CRL)

What measurement is used to determine age of gestation via ultrasound for the rest of the first trimester?

Cephalic, breech, trans

What are the three presentations that can be determined in a 2nd to 3rd Trimester Ultrasound?

Position and grading

What characteristics of the placenta are assessed in a 2nd to 3rd Trimester Ultrasound?

Adequate, increased, decreased

What characteristics of the amniotic fluid are assessed in a 2nd to 3rd Trimester Ultrasound?