Abstract
Sonography is the imaging modality of choice for diagnosing diseases of the female genital tract due to its high resolution, easy availability, low cost and lack of radiation. CT is not advocated for the primary evaluation of the female pelvis. However, with the advent of Multidetector CT (MDCT), females of all ages undergo CT scan of the abdomen and pelvis for myriad non-gynaecological diseases, e.g. subacute intestinal obstruction, abdominal lump, abdominal tuberculosis, appendicitis, ureteric colic, pancreatitis, oncological staging, follow-up, etc. Incidental female genital tract disorders were seen on these scans that are a dilemma for both, the radiologists and the clinicians. The objective of this pictorial review is to characterise the incidentally detected lesions of the female genital tract observed on 64-slice MDCT by correlating with sonography, if necessary, and establishing a clinico-radiological diagnosis. Our aim is to emphasise that the radiologist may be the first person to recognise a gynaecologic disorder and hence can play a significant role in patient management.
Similar content being viewed by others
References
Yitta S, Hecht EM, Mausner EV, et al. Normal or Abnormal? Demystifying Uterine and Cervical Contrast Enhancement at Multidetector CT. RadioGraphics 2011; 31: 647–661.
Gore RM, Newmark GM, Thakrar KH, et al. Pelvic incidentalomas. Cancer Imaging 2010; 10 Spec no A: S15–26.
Pannu HK, Corl FM, Fishman EK. CT evaluation of cervical cancer: spectrum of disease. Radiographics 2001; 21: 1155–1168.
Wildenberg JC, Yam BL, Langer JE, et al. US of the Nongravid Cervix with Multimodality Imaging Correlation: Normal Appearance, Pathologic Conditions, and Diagnostic Pitfalls. Radiographics 2016; 36: 596–617.
Helal MH, Mostafa AM, Mansour SM, et al. Loco-regional staging of cervical carcinoma: Is there a place for Multidetector CT? The Egyptian Journal of Radiology and Nuclear Medicine 2017; 48: 307–311.
Olpin J, Chuang L, Berek J, et al. Imaging and cancer of the cervix in low- and middle-income countries. Gynecologic Oncology Reports 2018; 25: 115–121.
Bipat S, Glas AS, Velden J van der, et al. Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review. Gynecologic Oncology 2003; 91: 59–66.
Hricak H, Yu KK. Radiology in invasive cervical cancer. American Journal of Roentgenology 1996; 167: 1101–1108.
Pergialiotis V, Bellos I, Thomakos N, et al. Survival outcomes of patients with cervical cancer and accompanying hydronephrosis: A systematic review of the literature. Oncol Rev 2019; 13: 387.
Yang C-Y, Lai M-Y, Yang W-C, et al. Cervical cancer with pyometra--an insidious cause of uraemia in a post-menopausal woman. Nephrol Dial Transplant 2006; 21: 2984–2985.
Narayanan P, Nobbenhuis M, Reynolds KM, et al. Fistulas in Malignant Gynecologic Disease: Etiology, Imaging, and Management. RadioGraphics 2009; 29: 1073–1083.
Revzin MV, Mathur M, Dave HB, et al. Pelvic Inflammatory Disease: Multimodality Imaging Approach with Clinical-Pathologic Correlation. Radiographics 2016; 36: 1579–1596.
Foti PV, Tonolini M, Costanzo V, et al. Cross-sectional imaging of acute gynaecologic disorders: CT and MRI findings with differential diagnosis-part II: uterine emergencies and pelvic inflammatory disease. Insights Imaging 2019; 10: 118.
Rezvani M, Shaaban AM. Fallopian tube disease in the nonpregnant patient. Radiographics 2011; 31: 527–548.
Multilocular Cystic Lesions in the Uterine Cervix: Broad Spectrum of Imaging Features and Pathologic Correlation: American Journal of Roentgenology : Vol. 195, No. 2 (AJR), https://www.ajronline.org/doi/full/10.2214/AJR.09.3619 (accessed 18 March 2021).
McEachern J, Butcher M, Burbridge B, et al. Adenoma malignum detected on a trauma CT. J Radiol Case Rep 2013; 7: 22–28.
Patel MD, Ascher SM, Horrow MM, et al. Management of Incidental Adnexal Findings on CT and MRI: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol 2020; 17: 248–254.
Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol 2018; 14: 270–284.
Patel MD, Ascher SM, Paspulati RM, et al. Managing incidental findings on abdominal and pelvic CT and MRI, part 1: white paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol 2013; 10: 675–681.
Zhang H. Bilateral Theca-lutein Cysts in One Pregnant Woman at MRI. International Journal of Clinical & Medical Images; 1, https://www.imagejournals.org/articles/bilateral-thecalutein-cysts-in-one-pregnant-woman-at-mri-mimicking-the-cystadenoma-21.html (2014, accessed 14 March 2021).
Telischak NA, Yeh BM, Joe BN, et al. MRI of Adnexal Masses in Pregnancy. American Journal of Roentgenology 2008; 191: 364–370.
Buy JN, Ghossain MA, Mark AS, et al. Focal hyperdense areas in endometriomas: a characteristic finding on CT. American Journal of Roentgenology 1992; 159: 769–771.
Baek IK, Kim HS, Jeon DS, et al. CT Findings of Endometrioma: Differential Points from Other Benign Complex Cystic Adnexal Masses. J Korean Radiol Soc 2016; 37: 725–732.
Funding
No funding was received for this purpose.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there are no conflicts of interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Gulati, S., Rathi, V., Jain, S. et al. Incidentalomas of the female genital tract on 64-slice MDCT: a clinico-radiological pictorial review. Abdom Radiol 46, 4420–4431 (2021). https://doi.org/10.1007/s00261-021-03086-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-021-03086-9