Preliminary Diagnosis: Ovarian Cyst
I. What imaging technique is first-line for this diagnosis?
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Ultrasound of the pelvis: transvaginal and/or transabdominal approach
II. Describe the advantages and disadvantages of this technique for diagnosis of ovarian cyst.
Advantages
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Does not expose patients to ionizing radiation
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Gold standard modality in evaluating the bilateral ovaries
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Offers exquisite detail of the arterial and venous vasculature of the ovaries
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Highly specific in detailing the quality of the cyst and any particular complexity of the cyst
Disadvantages
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Offers limited evaluation of the surrounding soft tissues and osseous structures
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Highly operator dependent
III. What are the contraindications for the first-line imaging technique?
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No specific contraindications to ultrasound exist.
IV. What alternative imaging techniques are available?
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CT of the pelvis
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MR of the pelvis
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of ovarian cyst.
CT of the Pelvis
Advantages
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More sensitive and specific in evaluating the surrounding soft tissues and osseous structures than other imaging modalities
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May evaluate for secondary ovarian complications better than other imaging modalities
Disadvantages
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Limited in sensitivity and specificity in evaluating for ovarian torsion
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Less sensitive and specific in detailing the ovarian structures
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Exposes patients to ionizing radiation
MR of the Pelvis
Advantages
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Does not expose patients to ionizing radiation
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Offers exquisite detail of the uterus and ovarian structures
Disadvantages
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Limited in sensitivity and specificity in evaluating for ovarian torsion
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May be subject to motion artifact and susceptibility-weighted artifact degrading image quality.
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Expensive
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Time consuming
VI. What are the contraindications for the alternative imaging techniques?
CT of the Pelvis
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May be contraindicated in pregnant patients
MR of the Pelvis
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Contraindicated in patients with non–MR-compatible hardware
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