Variety of pelvic inflammatory diseases on CT and MR imaging features.

Congress:

ECR 2019

Poster Number:

C-3163

Type:

Educational Exhibit

Keywords:

Genital / Reproductive system female, MR, Surgery, Abscess

Authors:

E. Yamashita, K. Nagawa, U. Sakurai, Y. Kobayashi; Tokyo/JP

DOI:

10.26044/ecr2019/C-3163

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3163

Fig. 1: PID, pelvic inflammatory disease

Fig. 2: PID,imaging modality

Fig. 3: PID, common findings of TVUS, CT, MRI

Fig. 4: PID, not common finding of CT, MRI

Learning objectives

To be familiar with the various types of pelvic inflammatory disease on CT and MR imaging. To understand common and not common findings of gynecologic emergencies on CT and MR imaging mimicking PID.

Background

Pelvic inflammatory disease (PID) is one of common infectious diseases among women. The etiology of PID is an ascending infection of female genital tract caused by microorganisms sexually transmitted. By spreading bacteria from the vagina to the cervix, adnexa and the peritoneal cavity, PID is considered series of infection as cervicitis, endometritis, pyometra, salpingitis, oophoritis, pyosalpinx, tubo-ovarian abscess (TOA). Many risk factors include multiple sexual partners, younger age, previous uterine procedure and intrauterine devices, IUD. Common and clinical symptoms of PID are known as pelvic...

Findings and procedure details

We present common and not common appearance of several types of PID on CT and MRI imaging. CT and MRI were performed in our hospital with patients at age from 20’s to 80’s who were suspected PID They were confirmed PID clinically or pathologically. Our case presentation is listed in a Table including TOA with IUD insertion or without IUD insertion, infected endometriotic cyst with prominent wall thickening or with slight wall thickening, pyosalpinx under steroid medication, chronic pyosalpinx caused by chlamydial infection, pyometra, infected...

Conclusion

PID presents wide spectrum of clinical course and involves from the vagina to the peritoneum. Knowing PID on CT and MR imaging features can be helpful to make the accurate diagnosis and lead to the appropriate treatment. The risk of infertility, ectopic pregnancy and peritoneal adhesion is possible to be decreased among young women based on radiographic features.

Personal information

References

1. Dohke M, Watanabe Y, et al. Comprehensive MR imaging of acute gynecologic diseases. Radiographics. 2000;20(6):1551-66 2. Revzin MV, Mathur M, et al.Pelvic Inflammatory Disease: Multimodality Imaging Approach with Clinical-Pathologic Correlation. Radiographics. 2016;36(5):1579-96. 3. Knoepp US, Mazza MB, et al. MR Imaging of Pelvic Emergencies in Women. Magn Reson Imaging Clin N Am. 2017;25(3):503-19. 4. Pickhardt PJ, Fleishman MJ, et al. Fitz-Hugh-Curtis syndrome: multidetector CT findings of transient hepatic attenuation difference and gallbladder wall thickening. AJR Am J Roentgenol. 2003;180(6):1605-6. 5. Sam JW, Jacobs JE,...