Radiology.Academy.Sk

Neuro Review
Appendix
Spleen
Stomach
Kidneys
Kidney
Pancreas
Pelvic congestion syndrome
Liver
Biliary
CT Abd Epiploic Appendagitis
Fractures Wrist
Wrist
Diffuse periosteal reaction
Signs in Uroradiology
Male breast
MRI Breast Indications
CT Head Cerebellar Mass
Biopsies
Diagnostic mammography
Screening mammography
Mammo Pearls
ACR Appropriateness Criteria Breast Cancer Screen
AVM types
CT Orbits
CT Abd NL
Chiari Malformations
Vesicoureteral Reflux (VUR)
Elbow
XRAY Abdominal Series

Abdomen
Cardio
Chest
Dictation Templates
General
GU
Mammography
MSK
neuro
Neuroradiology
NM
Nuclear Medicine
Pediatric
Physics
Ultrasound
Upload

Uterus

Ultrasonographic appearances of uterine pathology. Nulliparous uterus measures 7 x 5 x 3 cm.


Endometrial Stripe (ES) thickness

  • Secretory phase of MS (progesteron): ES < 15 mm
  • Proliferative phase of MS (estrogen): ES < 8 mm
  • Postmenopausal: ES < 5mm
  • Thickened ES ⇒ Endometrial Carcinoma, Polyp, Hyperplasia

Striated appearance of ES (triple layer) at mid cycle around ovulation ⇒ endometrium particularly receptive to implantation.
Tamoxifen (breast ca th.) has estrogenic effect causing endometrial hyperplasia with cysts and increased risk for endometrial carcinoma

Junctional zone

Hypoechoic layer surrounding endometrium (better seen on MRI)

Distorted by:

  • Adenomyosis
  • Fibroid
  • Endometrial cancer

Adenomyosis

Uterine endometriosis - extension of endometrium into the myometrium causing distortion of the junctional zone (multiple small hypoechoic lesions: moth-eaten appearance), small subcentimeter cysts in myometrium, enlarged uterus; MRI best for diagnosis

Fibroids

most commonly hypoechoic solid mass, however it can be heterogeneous to hyperechoic, show posterior acoustic shadowing, may calcify and necrose (hypoechoic areas within an solid mass)
  • Submucosal
  • Subserosal (pedunculated or sesile)
  • Myometrial

Uterine Versions

  • Anteversion: body tilted towards abdominal wall
  • Retroversion: body tilted away from abdominal wall (cervix on left)
  • Flexion: body folded on itself, including endometrial stripe, sharp angle

Postpartum Endometritis and RPOC

RPOC: Retained Products Of Conception
ES > 15 mm, fluid collection and gas (bright reflectors)
DDx: Ovarian vein thrombosis almost always occur on the right side and cause pain and fever

Hematocolpos

Premenstrual vaginal fluid collection from vaginal atresia, vaginal septum or imperforate hymen

Hematometros and Pyometros

Fertile age fluid collection in the uterus: blood or pus
Postmenopausal fluid collection in the uterus is never a normal finding → cervical stenosis or obstructing endometrial or cervical carcinoma, may become infected → Pyometros and septic

Postmenopausal ES > 5mm

  • Endometrial carcinoma
  • Polyp (supply vessel)
  • Hyperplasia
Usually present with vaginal bleeding → Endometrial bx or Sonohysterogram → Hysterectomy

Endometrial Atrophy

Postmenopausal vaginal bleeding with normal ES < 5mm