Main imaging modalities
In modern gynecology, the choice of method depends on the diagnostic task:
- Hysterosalpingography (HSG): used to check tubal patency and examine the uterine cavity. The optimal timing is days 5–7 of the cycle.
- Computed tomography (CT): provides detailed cross-sectional images. In gynecology, it is indispensable for the differential diagnosis of pituitary adenomas.
- Magnetic resonance imaging (MRI): the safest method, as it completely excludes ionizing radiation and provides a detailed study of soft tissues.
X-ray diagnostics of neuroendocrine disorders
Skull radiography remains an important step when searching for the causes of endocrine disorders. Physicians evaluate the condition of the sella turcica, the bony bed of the pituitary gland.
- Double contour sign or thinning of the sella walls may indicate a pituitary tumor.
- Digital impressions on the bones of the cranial vault indicate intracranial hypertension.
If abnormalities are detected on the radiograph, the patient is referred for a CT scan to clarify the diagnosis.
Pediatric use
Examination of female pediatric patients requires a special approach and informed parental consent.
- Ultrasound is the method of choice due to its safety.
- Hand radiography is performed to determine "bone age" and compare it with chronological age.
- If CT or MRI is required in infants and toddlers, sedation or anesthesia is often necessary.
To memorize the indications for HSG, use the "P-A-S" rule: Patency of tubes, Anatomy of the uterus, Synechiae/Adhesions.
Class and exam questions
Why is HSG performed strictly on days 5–7 of the cycle?
This is necessary to obtain the most reliable results and minimize the risk of false-negative findings.
What is the main advantage of MRI over CT?
MRI does not use ionizing radiation, making the method safe for the body even when repeated multiple times.
What is evaluated during a skull X-ray in gynecology?
First and foremost, the shape, size, and contours of the sella turcica are evaluated to rule out pituitary pathologies.
What else to study on this topic
- Technique for posterior vaginal fornix puncture (culdocentesis)
- Differential diagnosis of hyperprolactinemia
- Assessment of bone age via ossification centers
- Vaginoscopy algorithm in children
- Indications for diagnostic dilation and curettage
Master the entire topic in the "Obstetrics and Gynecology" course
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Other topics in the "Gynecology" section
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