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Physiological pelvic intraperitoneal fluid

Physiological pelvic intraperitoneal fluid refers to the presence of a small volume of free fluid in the pelvis, particularly the pouch of Douglas. It occurs in young females of reproductive age and can be a mimic of traumatic free fluid in abdominal trauma. Unfortunately, pelvic free fluid may...

Hysterosalpingogram

A hysterosalpingogram (HSG) is a fluoroscopic examination of the uterus and the fallopian tubes, most commonly used in the investigation of infertility or recurrent spontaneous abortions. Indications infertility: to assess uterine morphology and tubal patency Contraindications pregnancy act...

Clitoral ultrasound

Clitoral ultrasound is a modality for imaging clitoral pathology, which can be the etiology of female sexual dysfunction. It can also be performed before and after gynecologic surgery to assess clitoral anatomy and blood flow. The exam involves a transperineal component. Normal ultrasound anato...

Uterine artery embolization MRI (an approach)

Uterine artery embolization (UAE) is used as an alternative to hysterectomy in selected patients and MRI assessment is key in allowing not only pre-procedure assessment but also assessing post-procedural outcome. For a general discussion of the underlying condition refer to the article on uteri...

Ovarian-Adnexal Reporting and Data System Magnetic Resonance Imaging (O-RADS MRI)

The Ovarian-Adnexal Reporting and Data System Magnetic Resonance Imaging (O-RADS MRI) forms the MRI component of the Ovarian-Adnexal Reporting and Data System (O-RADS). This system aims to ensure that there is a uniform, unambiguous MRI evaluation of ovarian or other adnexal lesions, accurately ...

Deep endometriosis (transvaginal ultrasound)

Transvaginal ultrasound (TV) for deep endometriosis is a specialized ultrasound technique used for the detection of deep endometriosis (DE). It differs from a traditional pelvic ultrasound in that the scan is extended beyond the uterus and ovaries to assess the anterior and posterior pelvic comp...

Abdominal pain in pregnancy protocol (MRI)

The abdominal pain in pregnancy MRI protocol encompasses a set of MRI sequences for assessment of causes of non-traumatic abdominal pain in pregnancy. Note: This article aims to frame a general concept of an MRI protocol for the assessment of the abdomen in pregnancy. Protocol specifics will va...

Acute non-traumatic abdominal pain in pregnancy

Acute non-traumatic abdominal pain in pregnancy requires a considered imaging approach due to the increased risks of fetal demise associated with undiagnosed diseases such as perforated acute appendicitis. Ultrasound is the first-line modality due to its wide availability and ability to diagnose...

Female pelvic ultrasound

Pelvic ultrasound is usually the initial modality for imaging gynecologic pathology, including acute pelvic pain and chronic pelvic pain. The exam normally involves two components: a transabdominal (TA) evaluation and a transvaginal (TV) / endovaginal (EV) evaluation. Normal ultrasound anatomy ...

3D ultrasound

Three-dimensional (3D) ultrasound is a technique that converts standard 2D grayscale ultrasound images into a volumetric dataset. The 3D image can then be reviewed retrospectively. The technique was developed for problem-solving (particularly in obstetric/gynecologic exams) and to potentially re...

Deepest vertical pocket method

The deepest (maximal) vertical pocket (DVP) depth is considered a reliable method for assessing amniotic fluid volume on ultrasound 1,2. It is performed by assessing a pocket of a maximal depth of amniotic fluid which is free of an umbilical cord and fetal parts. The usually accepted values are...

Gynecological ultrasound set-pieces

The clinical history will nearly always lead to a short differential or the answer. Show off to the examiner that you have a structured approach to reporting and managing the patient. Structured approach uterus: size, version and shape (normal or variant which you should elaborate on and say w...

Polycystic ovarian syndrome in the exam

Getting a film with polycystic ovarian syndrome (PCOS) in a subfertile patient is one of the many exam set-pieces that can be prepared for. Description Transabdominal and transvaginal pelvic ultrasound shows an anteverted uterus with a normal size. There is diffuse thickening of the endometri...

Infertility in the exam

It is important to have a systematic way of approaching a case with subfertility in the exam. Ultrasound is the initial examination of choice. Always say that you would further assess the uterus with 3D ultrasound. You may also say that in my department we would perform a sonohysterogram or HS...

Acute pelvic pain

Acute pelvic pain is a common presenting symptom to the emergency department and radiologist. Pelvic ultrasound with transabdominal and endovaginal approaches is usually the first line imaging modality. Clinical presentation non-cyclical pain usually of more acute onset pain of <3 months dura...

IOTA ultrasound rules for ovarian masses

The International Ovarian Tumor Analysis (IOTA) group ultrasound rules for ovarian masses are a simple set of ultrasound findings that classify ovarian masses into benign, malignant or inconclusive masses. These rules apply to masses that are not a classical ovarian mass (e.g. corpus luteum, end...

Per vaginal bleeding in the exam

It is important to have a systematic way of approaching a case with per vaginal (PV) bleeding in the exam. Premenopausal embedded IUCD lost IUCD submucosal fibroid Pregnancy-related perigestational hemorrhage intrauterine fetal demise ectopic pregnancy ruptured ectopic cervical ectopi...

Pelvic pain in the exam

It is important to have a systematic way of approaching a case with pelvic pain in the exam. Most examinations are performed using ultrasound. Always say that you would further assess the uterus with 3D ultrasound. You may also say that in my department we would perform a sonohysterogram. Only...

Perigestational hemorrhage in the exam

Getting a film with pregestational hemorrhage in the exam is one of the many exam set-pieces that can be prepared for. Description Transabdominal and transvaginal (TV) pelvic ultrasound shows an anteverted uterus with an intrauterine gestational sac. MSD is 20 mm in TV study with a single, li...

Endometrial polyp in the exam

Getting a film with endometrial polyp in the exam is one of the many exam set-pieces that can be prepared for. Description Transabdominal and transvaginal pelvic ultrasound images in a lady with post-menopausal bleeding show an anteverted uterus with focal increased endometrial thickness to 1...

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