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Role of multidetector CT in the management of acute female pelvic disease

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Abstract

The purpose of this study is to highlight the role of multidetector CT (MDCT) in emergency radiology as a useful tool in the diagnosis and management of acute female pelvic disease and to describe key radiologic signs to improve differential diagnosis. We restrospectively reviewed MDCT findings of acute pelvic disease and its mimics in women reporting to the emergency room at our institution from December 2006 to August 2008. We describe MDCT findings of gynecologic and obstetric disorders such as hemorrhagic ovarian cysts, ovarian torsion, pelvic inflammatory disease, ruptured ectopic pregnancy, intravascular leiomyomatosis, blunt maternal trauma, and postpartum and post-cesarean section complications. We also briefly review gastrointestinal tract entities that may mimic these conditions. Although ultrasound is the imaging modality of choice for the evaluation of female pelvic pain, the role of MDCT remains essential in the management of patients in which gynecologic exploration is not diagnostic or undone since it is not the initial suspicion.

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Abbreviations

US:

ultrasound

MR:

magnetic resonance

MDCT:

multidetector CT

MPR:

multiplanar reconstructions

HU:

Hounsfield unit

MCT:

mature cystic teratoma

PID:

pelvic inflammatory disease

EP:

ectopic pregnancy

MTX:

methotrexate

IVC:

inferior vena cava

References

  1. Bennett GL, Slywotzky CM, Giovanniello G (2002) Gynecologic causes of acute pelvic pain: Spectrum of CT findings. Radiographics 22(4):785–801

    PubMed  Google Scholar 

  2. Siddall KA, Rubens DJ (2005) Multidetector CT of the female pelvis. Radiol Clin North Am 43(6):1097–1118. doi:10.1016/j.rcl.2005.07.005

    Article  PubMed  Google Scholar 

  3. Urban BA, Fishman EK (1995) Helical (spiral) CT of the female pelvis. Radiol Clin North Am 33(5):933–948

    CAS  PubMed  Google Scholar 

  4. Langer JE, Dinsmore BJ (1992) Computed Tomographic evaluation of benign and inflammatory disorders of the female pelvis. Radiol Clin North Am 30(4):831–841

    CAS  PubMed  Google Scholar 

  5. Gross BH, Moss AA, Mihara K, Goldberg HI, Glazer GM (1983) Computed Tomography of gynecologic diseases. AJR Am J Roentgenol 141(4):765–773

    CAS  PubMed  Google Scholar 

  6. Jeong Y, Outwater EK, Kang HK (2000) Imaging evaluation of ovarian masses. Radiographics 20(5):1445–1470

    CAS  PubMed  Google Scholar 

  7. Borders RJ, Breiman RS, Yeh BM, Qayyum A, Coakley FV (2004) Computed Tomography of corpus luteal cysts. J Comput Assist Tomogr 28(3):340–342. doi:10.1097/00004728-200405000-00006

    Article  PubMed  Google Scholar 

  8. Outwater EK, Siegelman ES, Hunt JL (2001) Ovarian teratomas: tumor types and imaging characteristics. Radiographics 21(2):475–490

    CAS  PubMed  Google Scholar 

  9. Kawamoto S, Urban BA, Fishman EK (1999) CT of Epithelial Ovarian Tumors. Radiographics 19:S85–S102

    PubMed  Google Scholar 

  10. Szucs RA, Turner MA (1996) Gastrointestinal tract involvement by gynecologic diseases. Radiographics 16(6):1251–1270

    CAS  PubMed  Google Scholar 

  11. Rha SE, Byun JY, Jung SE, Jung JI, Choi BG, Kim BS, Kim H, Lee JM (2002) CT and MR imaging features of adnexal torsion. Radiographics 22(2):283–294

    PubMed  Google Scholar 

  12. Kimura I, Togashi K, Kawakami S, Takakura K, Mori T, Konishi J (1994) Ovarian Torsion: CT and MR imaging appearances. Radiology 190(2):337–341

    CAS  PubMed  Google Scholar 

  13. Sam JW, Jacobs JE, Birnbaum BA (2002) Spectrum of CT findings in acute pyogenic pelvic inflammatory disease. Radiographics 22(6):1327–1334. doi:10.1148/rg.226025062

    Article  PubMed  Google Scholar 

  14. Ghiatas AA (2004) The spectrum of pelvic inflammatory disease. Eur Radiol 14:E184–E192. doi:10.1007/s00330-003-2142-y

    Article  PubMed  Google Scholar 

  15. Wilbur AC, Aizenstein RI, Napp TE (1992) CT Findings in Tuboovarian Abscess. AJR Am J Roentgenol 158(3):575–579

    CAS  PubMed  Google Scholar 

  16. Levine D (2007) Ectopic Pregnancy. Radiology 245(2):385–397. doi:10.1148/radiol.2452061031

    Article  PubMed  Google Scholar 

  17. Ahmed M, Zangos S, Bechstein WO, Vogl TJ (2004) Intravenous Leiomyomatosis. Eur Radiol 14(7):1316–1317. doi:10.1007/s00330-003-2186-z

    Article  PubMed  Google Scholar 

  18. Cohen DT, Oliva E, Hahn PF, Fuller AF Jr, Lee SI (2007) Uterine Smooth-Muscle Tumors with Unusual Growth Patterns: Imaging with Pathologic Correlation. AJR Am J Roentgenol 188(1):246–255. doi:10.2214/AJR.05.1070

    Article  PubMed  Google Scholar 

  19. Fielding JR (2003) MR imaging of the female pelvis. Radiol Clin North Am 41(1):179–192. doi:10.1016/S0033-8389(02) 00063-5

    Article  PubMed  Google Scholar 

  20. Lowdermilk C, Gavant ML, Qaisi W, West OC, Goldman SM (1999) Screening helical CT for evaluation of blunt traumatic injury in the pregnant patient. Radiographics 19:S243–S255

    PubMed  Google Scholar 

  21. Zuckerman J, Levine D, McNicholas MM, Konopka S, Goldstein A, Edelman RR, McArdle CR (1997) Imaging of pelvic postpartum complications. AJR Am J Roentgenol 168(3):663–668

    CAS  PubMed  Google Scholar 

  22. Garagiola DM, Tarver RD, Gibson L, Rogers RE, Wass JL (1989) Anatomic changes in the pelvis after uncomplicated vaginal delivery: a CT study on 14 women. AJR Am J Roentgenol 153(6):1239–1241

    CAS  PubMed  Google Scholar 

  23. Twickler DM, Setiawan AT, Harrell RS, Brown CE (1991) CT appearance of the pelvis after cesarean section. AJR Am J Roentgenol 156(3):523–526

    CAS  PubMed  Google Scholar 

  24. Leyendecker JR, Gorengaut V, Brown JJ (2004) MR Imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period. Radiographics 24(5):1301–1316. doi:10.1148/rg.245045036

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank Carlos Gutiérrez Pérez, C. for his assistance in preparing the photographs included in this manuscript.

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Authors and Affiliations

  1. Emergency Radiology Department, Hospital Universitario Doce De Octubre, Avenida de Córdoba S/N, 28041, Madrid, Spain

    Raquel Cano Alonso, Susana Borruel Nacenta, Patricia Díez Martínez, Navallas Irujo María, Laín Ibáñez Sanz & Elena Zabía Galíndez

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  1. Raquel Cano Alonso
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  2. Susana Borruel Nacenta
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  3. Patricia Díez Martínez
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  4. Navallas Irujo María
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  5. Laín Ibáñez Sanz
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  6. Elena Zabía Galíndez
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Correspondence to Raquel Cano Alonso.

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Cano Alonso, R., Borruel Nacenta, S., Díez Martínez, P. et al. Role of multidetector CT in the management of acute female pelvic disease. Emerg Radiol 16, 453–472 (2009). https://doi.org/10.1007/s10140-009-0808-8

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  • DOI: https://doi.org/10.1007/s10140-009-0808-8

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