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Insights into Imaging

, Volume 3, Issue 3, pp 265–275

First Online: 18 April 2012Received: 05 October 2011Revised: 26 January 2012Accepted: 21 February 2012


BackgroundThe role of various gynaecological imaging modalities is vital in aiding clinicians to diagnose acute gynaecological disease, and can help to direct medical and surgical treatment where appropriate. It is important to interpret the imaging findings in the context of the clinical signs and patient-s pregnancy status.

MethodsUltrasound and Doppler are readily available in the emergency department, and demonstrate features of haemorrhagic follicular cysts, ovarian cyst rupture, endometriotic cysts and pyosalpinx. Adnexal torsion may also be identified using ultrasound and Doppler, although the diagnosis cannot be safely excluded based on imaging alone. Computed tomography CT is not routinely employed in diagnosing acute gynaecological complications. However due to similar symptoms and signs with gastrointestinal and urinary tract pathologies, it is frequently used as the initial imaging modality and recognition of features of gynaecological complications on CT is important.

ResultsAlthough MRI is not frequently used in the emergency setting, it is an important modality in characterising features that are unclear on ultrasound and CT.

ConclusionMRI is particularly helpful in identifying the site of origin of large pelvic masses, such as haemorrhagic uterine fibroid degeneration and fibroid prolapse or torsion. In this article, we review the imaging appearances of gynaecological emergencies in non-pregnant patients.

Teaching points• Ultrasonography is easily accessible and can identify life-threatening gynaecological complications.

• Tomography scanners and computed radiography are not routinely used but are important to recognise key features.

• MRI is used for the characterisation of acute gynaecological complications.

• Recognition of the overlap in symptoms between gastrointestinal and gynaecological conditions is essential.

KeywordsGynecology Emergencies Ultrasonography Doppler Tomography scanners X-Ray computed Magnetic resonance imaging Ovarian cysts Endometriosis Dermoid cyst Torsion abnormality Leiomyoma Pelvic inflammatory disease  Download fulltext PDF

Autor: Oran Roche - Nikita Chavan - Joseph Aquilina - Andrea Rockall


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