Learning objectives
Review cases where the acute pathology was not initially suspected to be gynecologic.
Describe the US (transabdominal ultrasound),
CT and MR imaging features of the most common causes of acute gynecologic pathology.
Background
In our environment,
the initial evaluation of a patient with clinical suspicion of acute gynecological pathology is performed by the gynecologist and may include a transvaginal (TV) / endovaginal (EV) ultrasound exam.
However,
the acute gynecological pathology can simulate acute gastrointestinal,
urinary or musculoskeletal pathology and it represents a challenging diagnosis for the general radiologist.
For the other hand,
the gynecologist does not always arrive at the accurate or complete diagnosis initially.
Acute gynecological pathology is more frequent in premenopausal women.
Therefore,
ultrasonography (US) should...
Findings and procedure details
1.
Ovarian/adnexal related disorders:
1.1.
Follicular cysts:
During the first half of the menstrual cycle,
follicle-stimulating hormone (FSH) drives follicular enlargement.
One or more dominant follicles with a diameter of 18–25 mm emerge.
Acute pelvic pain may occur as the folliclegrows by capsular compression,at the time ofovulation (Mittelschmer z phenomenon),
or after cyst rupture or hemorrhage.
Although these follicles are cystic,
it is appropriate to refer to them as follicles and reserve the term cyst for structures larger than 2.5–3.0 cm.
Follicular cysts often measure...
Conclusion
Appropriate diagnosis and management requires radiologists to be familiar with the US,
CT and MR imaging features of gynecologic emergencies.
References
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Gynecologic causes of acute pelvic pain: spectrum of CT findings.
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