ABSTRACT
Computed tomography (CT) has become essential in the diagnostic evaluation of the female pelvic. CT allows accurate delineation of neoplastic and inflammatory processes and provides an effective means of guiding percutaneous needle biopsy of masses and aspiration/drainage of fluid collections. In the pregnant woman, pelvimetry and excretory urography can be performed using the CT scout view with a radiation dose significantly lower than with conventional x-ray techniques. This paper covers the clinically relevant technical considerations involved in performing CT on women and follows with an overview of normal female pelvic anatomy and frequently encountered pathologic conditions.
Subject(s)
Genital Diseases, Female/diagnostic imaging , Gynecology , Obstetrics , Pregnancy Complications/diagnostic imaging , Tomography, X-Ray Computed/standards , Biopsy , Drainage/methods , Female , Genital Diseases, Female/pathology , Genital Diseases, Female/surgery , Humans , Postoperative Care , Pregnancy , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/statistics & numerical dataABSTRACT
Therapeutic irradiation of the pelvis of a young female patient will result in loss of ovarian function. In a surgical technique termed ovarian transposition, the ovary is repositioned to the iliac fossa or paracolic gutter outside the radiation field. The computed tomographic (CT) scans and sonograms of five patients with cervical carcinoma who underwent this procedure were reviewed. The normal transposed ovary was of soft-tissue attenuation, often with one or more small cysts. Large cysts developed in the ovaries of three patients. One cyst was functional, another was due to a mesothelial inclusion cyst, and the third was most probably related to the transposition itself. Since the transposed ovary is difficult to palpate, CT or sonography can be used to demonstrate and follow up a cystic mass. Recognition of the appearance and location of the transposed ovary is important to avoid misinterpretation of a solid or cystic mass in patients who are at risk for tumor recurrence.
Subject(s)
Ovary/diagnostic imaging , Pelvis/radiation effects , Adult , Female , Humans , Ovarian Cysts/diagnostic imaging , Ovarian Cysts/etiology , Ovary/surgery , Postoperative Complications , Tomography, X-Ray Computed , Uterine Cervical Neoplasms/radiotherapyABSTRACT
The authors report an initially successful left gastric artery embolization performed because of massive upper gastrointestinal bleeding; the procedure was complicated by focal gastric and hepatic infarctions. These complications occurred in the absence of underlying factors known to predispose to ischemia. Low-grade gastric bleeding persisting after seemingly successful embolization of the left gastric artery may indicate ischemic gastritis and is an indication for endoscopy. In addition, the presence of a left hepatic artery completely replaced to the left gastric artery should alert one to the potential for hepatic necrosis.
