Ch. 38- Complementary Imaging of the Female Reproductive System

Commonly used MRI contrast agent

gadolinium

Utilizing mixed imaging parameters (T2 and T1) to create an optimal image

hybrid imaging

Having an intensity greater than surrounding structures

hyperintense

Set of parameters used to create a specific type of image (T1, T2, T2 FS)

MRI weightings (weighted image)

Time between the application of the 90 degree pulse and the peak of the echo signal

time to echo (TE)

Commonly used MRI technique to suppress signal from fat tissue

fat saturation (FS)

Method to detect, determine, and quantify the molecular component of tissue

spectroscopic

Time between pulses in a series of pulses for a single image

time to repetition (TR)

Applying pressure (compression) to displace structures such as bowel to bring intra-abdominal structures within the focal zone

graded-compression technique

Having an intensity less than surrounding structures

hypointense

Having the same image intensity as surrounding structures

isointense

Arrangement of radio frequency pulses and gradients that combine to create an image

sequence (s)

Signal that depicts brightness on the MRI image

high signal intensity

Choose the imaging modality with the largest field of view.

• MRI

• CT

• US

• both MRI and CT

both MRI and CT

MRI is based on the ability to excite ______ protons.

• cation

• hydrogen

• negative

• chromium

hydrogen

Name the device responsible for transmitting radio frequency within the MRI unit.

• NMV

• gradient coil

• antenna

• magnetic field

gradient coil

T2 and T1 are types of MRI:

• weighting

• images

• values

• displays

weighting

The MRI technique to selectively remove the signal from adipose protons is:

• TE

• TR

• FS

• NMV

FS

• fat saturation

Recent research has shown that gadolinium can accumulate in the human:

• liver

• spleen

• brain

• pancreas

brain

CT attenuation is the __________ of intensity as the radiation passes through a patient.

• gradual loss

• gradual increase

• coefficient

• value

gradual loss

What are the measurement units, from white to black, that CT uses to display images?

• duplex

• range

• monochrome

• hounsfield

hounsfield

Select the modality that offers the best tissue differentiation.

• US

• CT

• MRI

• CT and MRI

MRI

Vaginal agenesis can be responsible for:

• septa

• hematometrocolpos

• Gartner duct cysts

• a homogenous MRI image

hematometrocolpos

A malignant multilocular cervical cyst is known as:

• adenoma malignum

• cervicitis

• tunnel cluster

• endocervical hyperplasia

adenoma malignum

Name the imaging modality initially used to locate uterine fibroids.

• US

• CT

• MRI

• CT and MRI

US

_____ is used most often to predict the response of fibroids to uterine artery embolization.

• US

• CT

• MRI

• CT and MRI

MRI

MRI adds extensive diagnostic data to uterine studies by displaying how many uterine distinct soft tissue zones?

• two

• three

• four

• five

three

MRI T2 imaging displays simple ovarian cysts and simple paraovarian cysts as:

• high signal

• intermediate signal

• low signal

• fat saturation signal

high signal

• in T2 fluid is BRIGHT

Select an advantage that CT imaging has over MRI imaging as a complementary modality to US.

• no radiation exposure

• faster image acquisition

• extensive multiplayer positioning

• superior tissue differentiation

faster image acquisition

Dehiscence is seen:

• within the fundal endometrium

• within the fundal myometrium

• at the level of the external os

• in the lower uterine segment

in the lower uterine segment

• sutured/ stapled incision reopens

The two most likely modalities to demonstrate cervical competence are:

• CT, MRI

• CT, US

• US, MRI

• MRI, CT

US, MRI

Graded compression is a(n) ____________ technique that is helpful in locating the:

• US, appendix

• CT, fallopian tubes

• CT, adnexal fibroids

• MRI, pelvic hernia

US, appendix

Choose the reason uterine mullerian duct errors are imaged with MRI.

• it displays related anomalies such as kidney and vertebral body involvement

• its strength in evaluating soft tissue uterine configurations

• its ability to image the difficult body habitus

• the cost factor

its strength in evaluating soft tissue uterine configurations

________ is the most sensitive diagnostic imaging test for uterine fibroids.

MRI

A group of parameters used to create a specific type of image is known as MRI _____________.

weighting

______________ is a method to detect, determine, and quantify the molecular component of tissue.

Spectroscopic

MRI imaging relies on the ability to excite ___________ protons contained in water within the body tissues.

hydrogen

MRI contrast administration of _____________ during pregnancy is controversial.

gadolinium

CT imaging risks decrease into the _____ and ______ trimesters; however, research has shown that a slightly increased risk of childhood cancer is associated with radiation in utero.

2nd and 3rd

The cost of an MRI examination is ____________ compared to CT and US.

expensive

Appendicitis on MRI shows an appendiceal diameter over ____ mm, wall thickness over ___ mm, high signal intensity contents on T2 weighted images, and surrounding ________.

7; 2; fluid

MRI cannot visualize non-hydrogen structures in the pelvis such as __________ __________ or _______________ devices.

surgical implants; intrauterine

T2 demonstrates _____________ amniotic fluid filling the incompetent, dilated cervical canal up to the level of the “closed” cervix.

hyperintense

Incomplete ___________ of the endometrium and myometrium with an intact serosol layer characterizes uterine dehiscence.

rupture

The diagnosis of cystic teratoma is reasonable unequivocal because of the fat within the mass, which MRI detects with specific ____ sequences.

FS

MRI diagnosis of endometrioma is based on the detection of __________ products of different ages within a unilateral or bilateral adrenal mass.

blood

Fallopian tube fibroids are best characterized with MRI because this complementary modality can define the _________ location due to its exceptional tissue differentiation ability.

precise

Poorly defined polyps and ____________ masses may not be distinguishable with US, whereas MRI is usually able to differentiate these anomalies.

cancerous

An advantage of MRI as compared to US of the uterine myometrium and endometrium is MRI’s ability to depict defined ___________.

layers

When hyperplasia is suspected, MRI may only offer an advantage over US when the ________________ approach is not available or when the endometrial images demonstrate dubious findings.

endovaginal

During pregnancy, the _____________ ________ is poorly visualized as the signal is augmented and approaches the signal of the outer myometrium. The layers are seen again ____ days after deliver.

junctional zone; 15

The modalities, ______ and _______, are capable of viewing anatomy in many planes, which includes orthogonal and oblique.

US and MRI

Both ______ and _____ are widely utilized for cancer staging.

MRI and CT

Which imaging method is the primary method for OBGYN?

• US

• MRI

• CT

• nuc med

US

How is an MRI created?

electromagnetic radio waves

• gadolinium is rarely used for OB