Learning objectives
To identify the radiological findings on multidetector CT (MDCT) that allow the characterization of various gynecological and obstetric pathologies seen in the emergency room.
To recognize in what situations an immediate or postponed gynecological ultrasound is required after CT to complete the study.
To recognize when ultrasound and MDCT are the technique of choice.
Background
Although Ultrasound (US) and Magnetic Resonance are the imaging techniques of choice for suspected gynecological and obstetrical pathology,
MDCT is performed with increasing frequency as the initial imaging test for patients presenting to the emergency room with acute or chronic pelvic pain or pelvic mass of unknown cause.
In some cases,
CT is chosen to evaluate potential bowel or ureteral sources of pain; in others,
CT is chosen as the first test because it is readily available and decreases the perceived need for the clinician...
Imaging findings OR Procedure details
Protocol
Most of the studies included in this review were performed with a MDCT-40 Siemens Somathon scanner.
Abdominopelvic CT scans from the diaphragm to the symphysis pubis were obtained with a 20 x1.5 mm detector configuration,
a reconstruction interval of 4/1.5 mm,
and a tube rotation time of 0.35 s.
Nonionic intravenous contrast material (dose of 2 mL/Kg at a rate of 3 ml/s) was routinely administered.
A scan delay of 70 seconds after the beginning of intravenous contrast material injection was employed,
thus,
obtaining...
Conclusion
The recognition of the signs of certain gynecological conditions on CT imaging in the emergency would help to achieve an accurate diagnosis and characterization,
avoiding further and unnecessary imaging tests for confirmation.
There are situations that may require an immediate study with US to complete the diagnostic evaluation in cases where CT is not conclusive,
such as ovarian torsion.
Ultrasound is the imaging modality of choice for the diagnosis of ectopic pregnancy.
However,
we must recognize the signs of this complication when CT is performed...
Personal Information
Authors:
Beatriz Bandrés,
MD; María Velasco; MD; Alberto Mingo,
MD; Ignacio Gallego,
MD; Beatriz González,
MD and Lourdes del Campo,
PhD.
Contact e-mail:
[email protected]
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