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Home , Empty sella syndrome, Gonadal ridge, Hypophysitis, Leydig cell hypoplasia, Leydig cell tumour, PELVIS syndrome

Index

11b-Hydroxylase deficiency, 36 American Society of Reproductive Classification, 17,20 Desmolase deficiency, 36 66–67 17-Hydroxylase deficiency, 158 Anaesthesia, 2–3 17b-Hydroxysteroid dehydrogenase type, 3, 130 Excess Society diagnostic criteria, 156 17b-OH-dehydrogenase deficiency, 36 Androgen insensitivity syndrome 21-Hydroxylase deficiency—(see also Congenital adrenal complete, 5, 44, 164–166 hyperplasia-classic), 35, 39, 42, 140, 160 diagnostic criteria, 165 3b-Hydroxysteroid hydrogenase deficiency, 35–36 imaging, 44–45, 165 46,XX Disorders of sex development, 36, 39, 42–43 mild, 164 5a-Reductase deficiency, 35–36, 46–47 partial, 44–45, 164–165 b-hCG level, 182, 199, 201–202, 206 Androgen receptor, 44 , 44, 164 Anorexia nervosa, 148, 150 A Anosmia, 125 Abdominopelvic cyst (see Cyst—abdominopelvic) , 147 , 137, 156 Anti-Müllerian hormone, 22, 33–34, 127, 130, 160 Addison disease (see Adrenal insufficiency) Assessment of skeletal maturity (see ) Adenomyosis, 205 Autoimmune oophoritis, 148, 158, 160 Adenomyotic cyst, 205 Adnexa, 92 Adnexal B masses, 185 Balanced translocations, 158 torsion (also see Ovarian Torsion), 185 Bartholins glands, 30 volume ratio, 175, 177, 190, 193 Beckwith-Wiedemann syndrome, 141, 161, 218 Adrenal Blepharophimosis-ptosis-epicanthus adenoma, 140–141, 161 inversus syndrome, 158 androgen-secreting tumour, 132, 156 Blood dyscrasia, 147 cerebriform morphology, 40 Body mass index, 16, 118, 134 carcinoma, 140–141, 161–162 Bone age insufficiency, 158, 159 automated analysis, 108 normal imaging appearances, 103, 106–107 Fels method, 105, 118 oestrogen-secreting tumour, 132–133 Greulich and Pyle, 105, 118 rest tumour, 42, 160 Tanner-Whitehouse methodologies, 105 Adrenarche, 117, 131 Bone mineral exaggerated, 131–132 content, 108 premature, 115, 117, 130 density, 109 Adrenocortical tumour, 116, 140, 161 Breast Adrenocorticotropic Hormone deficiency, 140 abscess, 233–234 Alphafetoprotein, 211 amastia, 233 Amenorrhoea aplasia, 232 clinical assessment, 149 asymmetry, 231–232 endocrine investigations, 149 athelia, 232 primary, 148, 151 clinical evaluation, 230 secondary, 148–149 cyst, 234–235

G. Mann et al. (eds.), Imaging of Gynecological Disorders in Infants and Children, Medical . 247 Diagnostic Imaging, DOI: 10.1007/978-3-540-85602-3, Ó Springer-Verlag Berlin Heidelberg 2012 248 Index

B(cont.) atresia, 56 development, 117, 132, 149, 226–227 stenosis, 147, 149 , 226 Cervicovaginal atresia, 68 fibroadenoma, 239–240 fibrocystic disease, 236 anatomy, 84, 86 galactocele, 236 MRI appearances, 88–89 giant fibroadenoma, 240 ultrasound appearances, 86 haemangioma, 238 Chemotherapy, 119, 158 haematoma, 237 , 201–202, 211 hypomastia, 233 Chromosomal sex, 22, 32 hypoplasia, 231–232 Classification lobule, 228 American Society of , 66–67 lymphangioma, 237 clinico-embryological, 67 lactiferous ducts, 226 PVE, 41 lymphatic drainage, 228 Prader, 41 , 242 Clear cell carcinoma, 221 macromastia, 233 Clinico-embryological Classification, 67 malignant masses, 241–242 Cliteromegally, 61–62 mamma aberrata, 230 , 28–29 mammary duct ectasia, 236 , 27, 35 mammary ridge, 226 Cloacal mammography, 228 malformation, 7, 51–52, 56–59, 70 management of solid mass, 238 membrane, 27–28, 35 metastases, 241 Colour Doppler, 6–7 milk lines, 226 Complete androgen insensitivity syndrome (see androgen nipple discharge, 243 insensitivity syndrome) phyllodes tumour, 240 Complete hydatiform mole, 174, 201 polymastia, 230 Computed Tomography polythelia, 230 bowel preparation, 15 postnatal development, 226 contrast medium, 14 primary carcinoma, 242 indications, 13 primary mammary bud, 226 scanning parameters, 13 pseudomamma, 230 Congenital adrenal hyperplasia retroareolar cyst, 235 classic, 35, 39, 116, 130, 132–133, 139–140, 161 phabdomyosarcoma, 242 lipoid, 160 secondary mammary bud, 226 non-classic, 39, 130–133, 139 secondary tumours, 243 virilising, 148 supernumerary tissue, 230 Congenital androgen insensitivity syndrome (see Androgen Tanner staging, 227 insensitivity syndrome) ultrasound, 228 Congenital disorders of glycosylation, 158 vascular malformation, 237 Constitutional delay in growth and , 148 vascular supply, 228 , 97 virginal hypertrophy, 233 , 97, 100–101 Bulimia nervosa, 148 Corpus luteum cyst, 179–184 Cortical cord (see secondary sex cord) Craniopharyngioma, 116, 119, 135 C Cryptomenorrhoea, 147, 185 , 24, 30 Criteria cyst, 24, 61 Androgen Excess Society diagnostic, 156 hydrocele, 61 Rotterdam consensus, 156 Carcinoma Cryptomenorrhoea, 147, 185 adrenal, 140–141, 161–162 Cushing syndrome, 118, 130, 137, 140, 148, 156, 160 breast primary, 242 Cyst ovarian, 210 abdominopelvic, 52 Carney complex, 141 Bartholin duct, 61 Cell duplication, 52–53 granulosa, 34 Gartner duct, 61–62 Leydig, 33–34, 116, 138 hymenal, 61 Sertoli, 33, 129 Kobelt, 195 theca, 34 mesonephric, 61, 195 Cervical mesothelial, 195 Index 249

Müllerian, 61 of female reproductive tract neonatal ovarian (see —neonatal) childhood, 83 paramesonephric, 195 during puberty, 83 paratubal, 195 infancy, 82 paraurethral, 61 onset of puberty, 83 paraurethral, 182 Endodermal sinus tumour, 168, 210–211 peritoneal inclusion, 195 Endometrial polyp, 147 Skene duct, 61 Endometrioma, 182–184, 187, 196, 202–204 urothelial, 61 Endometriosis vaginal wall inclusion, 61 aetiology, 202 Wolffian, 195 imaging, 202–204 Cystography, 13 staging, 203 Endometritis, 147, 175, 198 (also see ), 3, 13, 86, 97–99, D 102, 104 Daughter cyst sign, 52–53 Epitheliod site trophoblastic tumour, 174, 201 Defects in androgen biosynthesis (also see Androgen , 26, 29–30 insensitivity syndrome), 36, 43, 119, 127 External genitalia differentiation, 22 Defects in testis determination, 42, 130 Dehydroepiandrosterone, 83 Dehydroepiandrosterone sulphate, 83 F DeMorsier syndrome (see Septo-optic dysplasia) Fallopian tubes Denys-Drash syndrome, 39–40 anatomy, 92, 96 Dermoid cyst (also see Ovarian ), 16, 182, 188–189 isolated torsion, 193 Development imaging, 92 fallopian tubes, 34 Fibroid uterus (see Uterine—leiomyoma) (also see gonadal differentiation), 3, 40, 46 Fitzhugh-Curtis syndrome, 198 cervix, 26, 35 Follicle stimulating hormone, 82, 117, 123 external genitalia, 28–29, 38 Follicle stimulating hormone deficiency, 117, 129, 132 fallopian tubes, 26 Foreign body (see Vaginal—foreign body) uterus, 26, 35 Fragile X Mental Retardation-1 gene, 160 , 26, 28, 38 Fragile X permutations, 158 Differentiation Fundocervical ratio, 6, 97 external genitalia, 22 gonadal, 3, 22–24, 40, 46 Müllerian duct differentiation, 22–26 G sexual, 23 Galactorrhoea, 152, 243 DiGeorge syndrome, 158 Galactosaemia, 158 Disorders of sex development Gartner duct (see Cyst—Gartner duct) aetiology, 35 Gartner’s pseudocyst, 68 classification, 35 Genital outflow tract stenosis, 56 clinical assessment and management of delayed Genital prolapsed, 61 presentations, 37 Genital Renal Ear and Skeletal syndrome, 76 initial clinical assessment and management, 35 Genital ridge long term clinical management, 48–49 agenesis, 68 nomenclature, 32 hypoplasia, 68 radiological assessment, 35 , 35, 41–42 Dominant (Graafian) follicle, 97, 103, 155 Genitography Double wall sign, 52–53, 63 contraindications, 13 Dual-energy X-ray absorptiometry, 109 indications, 11 Ductal differentiation, 22 technique, 12 Duplication cyst (see Cyst—duplication) Genotype Dysfunctional uterine bleeding, 147 tumour, 54, 152, 210–214 , 165, 211, 214 , 135–136 Dysmenorrhoea, 146–147, 176 Gestational trophoblastic neoplasia, 201 bipotential (see also Indifferent gonad), 33 E intraabdominal, 45 Eating disorders, 148 labial, 37, 63, 164–165 Ectopic pregnancy (see Pregnancy—ectopic gestation) streak, 38, 43, 129–130, 158–160 , 148, 152 Gonadal 250 Index

G(cont.) Hypogonadotropic , 119, 121, 125, 151 agenesis, 148 Hypogonadotropic hypogonadism—idiopathic, 151–152 differentiation, 24 Hypomenorrhoea, 147 dysgenesis, 119, 127, 129–130, 148, 158 Hypooestrogenism, 150 complete, 35–36, 46–47 Hypoparathyroidism, 158–159 partial, 33, 43 Hypophosphatemic rickets, 138 ridge, 22–23 , 22–24 congenital, 47 Gonadoblastoma, 39, 127, 152, 165, 211 idiopathic, 119 Gonadotoxic drugs, 148 Hyposmia, 125 , 82–84, 96 Hypothalamic Gonadotropin glioma, 119, 135 receptor gene , 158 hamartoma, 116, 133–135, 151 releasing hormone, 83, 117 infiltration, 148 releasing hormone-releasing neurones, 116, 123 irradiation, 148 Gorlin Syndrome, 218 tumour, 148, 150–151 Granulosa cell, 34 Hypothalamic-pituitary-gonadal axis, 102, 117, 130, 149 Granulosa-theca cell tumour, 214 , 117–118, 120, 129–130, 139, 147, 152, 155, 159 deficiency, 120–121, 125–126 excess, 137 Growth spurt, 117, 125 I , 24 Idiopathic Hypogonadotropic Hypogonadism Gynaecological tract obstruction, 51–52, 56–58, 78, 163, (see Hypogonadotropic Hypogonadism—Idiopathic) 185–186 Imperforate , 16, 56, 61, 149, 162 Implantation, 97 Indifferent gonad, 22–23, 26, 33 H Infundibulopelvic , 24–25, 93–94 Haemangioma, 169 Inguinal hernia, 45, 51, 53, 61–62, 164 Haematocolpos, 78, 163, 186 Inhibin, 97, 138 Haematometrocolpos, 163, 186 Interlabial mass, 56, 60–61 Haematosalpinx, 184, 194, 196, 201 Intermenstrual bleeding, 147 Haemoperitoneum, 182–184, 195, 201, 206 (also see Disorders of sex development), 32–37 Haemorrhagic ovarian cyst (see Ovarian cyst—Haemorrhagic) Isolated premature Haemosiderosis, 148 adrenarche, 115, 117, 130 Height-target, 117, 131 menarche, 117, 131 Herlyn–Werner–Wunderlich syndrome, 76, 79 thelarche, 117, 130–131, 231 Hermaphrodite (also see ovotesticular disease), 33 Holoprosencephaly, 119–121, 135 Human Papilloma Virus, 221 J Hydatid, 26 Junctional zone (also see Uterus-junctional zone), 88, 102 Hydatid cyst of Morgani, 195 Juvenile , 116, 138–139 Hydatiform mole, 174, 201 Hydranencephaly facial cleft syndrome, 121 , 51–52, 56–58, 60 K Hydrometrocolpos, 56, 58 Kallman syndrome, 119, 121–125, 148 Hydrosalpinx, 195 Hymen anatomy, 27 L atresia, 68 imperforate, 56, 61, 149, 163–164, 185 majora, 28–29, 35, 40 septate, 68 minor, 28–29, 35 Hyoscine-N-butylbromide, 9 Labial Hyperandrogenaemia, 156 gonad, 37, 63, 164–165 , 156 hypertrophy, 61 Hypercalcaemia, 211 Labioscrotal folds, 28, 35 Hypergonadotropic hypogonadism, 119, 127, 149, 157 Langerhans cell histiocytosis, 116, 119, 126–127, 148 Hypermenorrhoea, 147 Leptin, 83 Hyperparathyroidism, 137 Leucorrhoea, 167 , 137, 148–149, 155 , 33–34, 116, 138 Hyperthyroidism, 148, 152 , 36 Index 251

Li-Fraumeni syndrome, 141, 161, 218 Mesothelioma, 205, 210 Ligament , 24–25 broad, 96 Metanephros, 25 cardinal, 87 Metrorrhagia, 147 infundibulopelvic, 93–94 Midline brain abnormalities, 119 ovarian, 94 Mittelschmerz, 174–175, 177 round, 94 Mosaicism, 36–37, 43 sacrospinal, 94 Mucocolpos, 163 uterosacral, 94 Mucocutaneous candidiasis, 158–159 Longitudinal septum (see Septum—longitudinal) Müller’s tubercle, 26–27, 35 Luteinising hormone, 82, 117, 119, 123, 127 Mullerian duct (see also ), 33–34, 43, deficiency (see also Leydig 66–67 cell hypoplasia), 36, 82, 119–120 agenesis, 66–67, 162 receptor defect, 119, 127 disorder of lateral fusion, 73–74, 162 Lymphoma, 210 disorder of vertical fusion, 68, 162 Lynch familial neoplasia, 161 hypoplasia, 162 organogenesis, 26 Multicystic dysplastic , 77, 164 M Multifollicular morphology, 100, 151 Maffucci’s syndrome, 138 Multiple Endocrine Neoplasia type 1, 137, 141, 161 Magnetic Resonance Angiography, 11 MURCS association, 75, 162 Magnetic Resonance Imaging Mutation coil selection, 9 STK11 (Serine/threonine kinase 11) gene, 116, 138 contraindications, 8 CYP21A2 gene, 160 Diffusion Weighted Imaging, 11 DAX-1 (dosage-sensitive sex reversal-adrenal fetal, 18 hypoplasia, 36 field strength, 8 p53 gene, 141 indications, 8 SF1 (), 36, 43 parallel imaging, 9 SOX-9 (SRY box 9), 34 patient preparation, 8 SRD5A2 gene, 46 scanning planes, 10 SRY (sex-determining region T1-weighted imaging, 11 of the ), 36, 116, 129 T2-weighted imaging, 10 WT-1 (Wilm’s Tumour-1), 36, 43 Magnetic Resonance Urography, 11 CHD7 (Chromodomain helicase-DNA-binding Mammography, 228 protein 7 gene), 116, 123 Masculinisation—XX female, 33 FGF8 (Fibroblast Growth Factor 8) gene, 116, 123 Massive ovarian oedema, 193, 218 FGFR1 (Basic fibroblast ) Mature cystic teratoma (also see ovarian teratoma), 179, 188 gene, 116, 123 Mayer-Rokitansky–Küster–Hauser syndrome, 68, 75, 162 HESX1 (HESX homeobox 1) gene, 116, 120–121 McCune-Albright syndrome, 116, 130, 135–137 KAL1 (Anosmin-1) gene, 116, 123 Meconium calcifications, 16 LHX3 (LIM homeobox 3 LHX3) gene, 116, 120 Menarche, 83–85, 96, 117, 129, 146–148 LHX4 (LIM homeobox 4 LHX4) gene, 16, 120 Menometrorrhagia, 147 POU1F1 (POU class 1 homeobox 1) gene, 116, 120 Menorrhagia (see Hypermenorrhoea) PROK2 (Prokineticin-2) gene, 116, 123 Menstrual cycle PROKR2 (Prokineticin-2 receptor) gene, 116, 123 endocrinology, 97 PROP1 (PROP paired-like homeobox 1) gene, 116, 120 follicular phase, 97 SOX2 (SRY [sex determining region Y]-box 2) luteal phase, 97 gene, 116, 120 MR imaging of endometrium, 101, 104 SOX3 (SRY [sex determining region Y]-box 3) ovulation, 97 gene, 116, 120 US imaging of endometrium TBX19 (T-box 19) gene, 116, 120 , 97 , 86, 88, 101–102 Proliferative (follicular) phase, 98 Secretory (luteal) phase, 98 Menstrual disorders—classification, 146–147 N Mermaid syndrome, 58 Nabothian cyst, 91 Mesonephric Neonatal ovarian cyst (see Ovarian cyst—neonatal) cyst (see Cyst—mesonephric) Neuroblastoma, 210 duct, 23, 25–26 Neurofibromatosis type 1, 116, 118, 134–135, 218 , 22, 25 Nonclassical congenital adrenal hyperplasia, 148 , 92 Noonan syndrome, 118 252 Index

O multifollicular, 100 Obstruction of the gynaecological tract, 51–52, 56–58, 78, 163, neonatal, 3–5, 36, 38 185–186 streak, 129, 148 Olfactory stroma, 84, 94, 101 bulbs, 124–125 supernumerary, 25 gyri, 124 ultrasound appearances at puberty, 9, 100 placode, 123 ultrasound appearances in prepubertal child, 94, 98 sulci, 124, 125 ultrasound appearances in the neonate, 94, 98 Oligomenorrhoea, 146–147, 152, 155 volume normative data, 99 Oligoovulation, 147 zonal anatomy on MR, 102, 105 Ollier’s syndrome, 138 Overvirilisation—XX female, 33 Oopherectomy, 119, 148 Ovotesticular disorder of sexual differentiation, 36, 47–48 Optic Ovotestis, 47–48 nerve hypoplasia, 121 Ovulation (see Menstrual cycle—ovulation) pathway glioma, 116, 134, 135 Oral contraceptives, 147 Ovarian P androgen-secreting tumour, 132, 156 Pallister-Hall Syndrome, 135 artery, 88 Paramesonephric autonomous cyst (see Ovarian – functioning cyst) differentiation, 26 carcinoma, 210 duct, 23–26 dominant follicle, 97, 103, 155 , 93 dysgenesis, 129 Paraneoplastic syndrome, 211 functional tumours, 138, 140 Paraphooron, 26, 29–30 germ cell tumour (see Germ cell tumour) Paraurethral irradiation, 148, 160 cyst, 61 ligament, 24–25 glands, 28–29 premature failure, 129, 147–148 Partial androgen insensitivity syndrome primary insufficiency, 127, 158–160 (see Androgen insensitivity syndrome—partial) oestrogen-secreting tumour, 130, 139 Partial hydatiform mole, 174, 201 secondary tumours, 218 Pectus excavatum, 232 teratoma Pelvic immature, 210–211 abscess, 16–17 mature cystic, 6, 217 free fluid, 173, 181, 184, 192, 205–206 , 215 inflammatory disease, 198 torsion, 119, 148, 190 irradiation, 158 Ovarian cyst pain adolescent, 179 acute, 174–176 benign masses, 179 causes, 174–175 childhood, 177–178 chronic, 174–176 complex, 50, 53–55 cyclical, 176 definition, 177 radiotherapy, 117, 119 dermoid, 16, 182, 188–189 PELVIS syndrome, 169 fetal, 18 Perihepatitis, 198 follicular, 182 Perimetrium, 86 functioning, 116, 130, 133, 136–137, 147 Periovulation, 91, 103 giant, 54 Peritoneal inclusion cyst, 195 haemorrhagic, 180–181, 184 Peutz-Jeghers syndrome, 116, 138 indications for surgical resection, 182 Pituitary luteal, 177 abscess, 148 neonatal, 52, 54 adenoma, 118, 136, 140–141, 148, 151 theca lutein, 179 agenesis, 119–120 epithelial, 210 apoplexy, 153 ectopic, 47 anatomy, 94 , 148 cortex, 22, 33, 105 infiltration, 148 descent, 24, 34 irradiation, 148 ectopic, 24, 36 macroprolactinoma, 148 follicle, 95–96 normal MR appearances, 103, 107–108 inguinal, 24, 33, 164–165 resection, 148 medulla, 33, 94, 105 stalk interruption syndrome, 119 Index 253

mutations, 120–121 isosexual, 138 tumours, 151 non-isosexual development, 35, 47 Placental normal development, 117 aromatase deficiency, 36 physical changes, 84 site trophoblastic tumour, 174, 201 precocious, 61, 103, 106, 108, 116–118, 131–134, 138, 215 Poland syndrome, 232 pseudo-precocious, 117, 131, 133, 138, 215 Polycystic ovarian morphology, 155 true precocious, 117, 130, 134 Polycystic ovarian syndrome, 141, 147–148, 155–157 PVE classification, 41 Polyglandular failure Type I, 158–159 Type II, 158–159 Q Polymenorrhoea, 147 Quantitative Polyostotic fibrous dyplasia, 135, 137–138 Computed Tomography, 110 Portio supravaginalis cervicalis, 86, 93 Quantitative Ultrasound, 111 Portio vaginalis cervicalis, 86 , 147 Posterior pituitary-ectopic, 47 R Post-traumatic hypopituitarism, 126, 153 Radiographs, 15 Pouch of Douglas (see Rectouterine Pouch) Rathke’s cleft cyst, 153, 155 Prader Classification, 41 Rectal duplication, 61 (see Puberty—precocious) Rectouterine Pouch Pregnancy anatomy, 91 ectopic gestation, 200 free fluid, 91, 96 intrauterine gestation, 199 imaging, 88, 91 molar, 200 Renal agenesis, 68, 77, 165 Premature , 22 adrenarche, 115, 117, 130 Rhabdomyosarcoma menarche, 117, 131 genitourinary, 60, 61, 168, 218, 219, 220, 221 thelarche, 117, 130–131, 231 uterus and cervix, 210 ovarian failure (see Ovarian—premature failure) vagina, 60, 61, 168, 210 thelarche, 227, 231 Rotterdam consensus criteria, 156 Primary Ovarian Insufficiency, 127, 158, 160 Primary sex cord, 22–23 Primitive germ cell (see Primordial germ cell) S Primordial germ cell, 22–23 SACRAL syndrome, 169 , 97, 100 Sarcoidosis, 148 , 83–84 , 61 Prolactin deficiency, 120, 136 Schizencephaly, 121 Prolactinoma, 147, 149, 152, 156 Secondary sex cord, 22–23 Prolapsed Sedation, 2–3 ectopic cecouteroecele, 61 Septo-optic dysplasia, 16, 119, 121, 135 ectopic uteroecele, 61 Septum , 61 longitudinal, 149 Pronephros, 25 transverse, 56, 149 Pseudohermaphrodite , 33, 129 female, 33 Sertoli–Leydig cell tumour, 116, 138, 212, 214–215 male, 33 Sex Type Ia, 158 cord Psychogenic stress, 147 primary, 22–23 Pubertal development secondary, 22–23 biochemical evaluation, 118, 129–130 determination, 34 clinical assessment of abnormal puberty, 117 differentiation radiological assessment of pubertal stage, 115, 118, female, 33 129–131 male, 33 Puberty reversal (see also Swyer syndrome), 33, 43 delayed, 83, 103, 108, 119 Sexually transmitted diseases, 147 endocrine changes, 83 Sheehan’s syndrome, 148 gonadotropin dependent precocious Sign (see Puberty—true precocious) beads-on-a-string, 196 gonadotropin independent precocious daughter cyst, 52–53 (see Puberty—pseudo-precocious) dermoid mesh, 189 254 Index

S(cont.) Tubo-ovarian abscess, 174–175, 180, 182, 190, 193, 196–198 dermoid plug, 189 Tumour double wall, 52–53, 63 adrenal androgen-secreting, 132, 156 flapping sail, 174, 180, 182, 194–196 adrenal oestrogen-secreting, 132–133 shading, 202, 205 adrenal rest, 42, 160 split, 196 adrenocortical tumour, 160, 162 string of beads, 196 germ cell, 54, 152, 210–214 string of pearls, 157 granulosa-theca cell, 214 tip of the iceburg, 189 hypothalamic, 148, 150–151 waist, 196 ovarian functional, 138, 140 whirlpool, 182, 193 ovarian oestrogen-secreting, 130, 139 Sinovaginal ovarian secondary, 218 bulb, 26 pituitary, 151 node, 26–27 placental site trophoblastic, 174, 201 Sirenomelia, 58 Sertoli-Leydig cell, 116, 138, 212, 214–215 Skeletal maturity score, 105 virilising, 160, 162 Skene Turner duct cyst (see Cyst—Skene duct) 45,XO/46XX, 130 glands, 28–29 45,XO/46XY, 129 Spasmolytic agents, 8 , 217, 221 45,XO, 119, 127–130 SRY 45,X, 158 gene, 33 45,X and 46,XY mosaicism, 158 protein, 22, 26, 35 StAR protein mutatation, 160 U protein deficiency, 36 Ultrasound Stratum 3D, 67, 69 basalis, 99 antenatal, 17 functionalis, 99 hysterosonography, 69 Streak indications, 3, 8 gonad (see Gonad—streak) patient preparation, 4 ovary (see Ovary—streak) probe selection, 4 Structural anomalies of scanning planes, 5, 7 classification systems, 41, 66–68 transabdominal, 3 MRI protocol, 69 transperineal, 6, 16 Suspensory , 93 transrectal, 8 Swyer syndrome, 129, 158 transvaginal, 7–8, 69 Symphyseal diastasis, 15 Undermasculinisation—XY male, 33 Undervirilisation—XY male, 33 Undifferentiated gonad (see indifferent gonad) T Urethral Tanner staging—Breast, 227 folds, 28, 35 (see Ovarian teratoma) groove, 28, 35, 42 Thalassaemia, 158 polyp, 61 Theca cell, 34 Urogenital Thecoma, 215 membrane, 27–28 Thelarche (also see Breast—development), 84, 118, 131, 227 ridge (see ) Thelarche variant, 115, 117, 131 , 12, 27–28, 35, 37, 40–41, 56–58, 63 Thyroid dysfunction, 148, 155 Urogenital sinus anomalies, 68, 71 Thyroid stimulating hormone deficiency, 116 Urorectal septum, 27–28, 35 Transabdominal ultrasound (see Ultrasound—transabdominal) Urothelial cyst (see Cyst—urothelial) Transperineal ultrasound (see Ultrasound—transperineal) Uterine Transrectal ultrasound (see Ultrasound—transrectal) artery, 88 Transvaginal ultrasound (see Ultrasound—transvaginal) artery Doppler, 95 Transverse septum, 56, 149 dysfunctional bleeding, 147 Traumatic brain , 148 Uterus X, 158 agenesis, 65–66, 148 Trophoblast, 97 anatomy, 86 True Hermaphrodite (also see ovotesticular disease), 33 anteflexion, 87 Tuberculosis, 148 anteversion, 87 Index 255

arcuate, 73 longitudinal septum, 186 bicornuate, 72–73 MRI appearances, 85–86 corpus, 86, 88, 97, 100–101 septa, 185–186 DES-exposed, 66, 74 stenosis, 68, 149, 185 didelphys, 4, 9, 73–74, 76–77, 163–164, 185, 187, 189 transverse septum, 67, 78, 185 fibroid, 204–205 ultrasound appearances, 84–85 fundal-cervical ratio, 6 Vaginal fundus, 88, 90, 95 bleeding, 166–167 hypoplastic, 66, 68 discharge, 61–63, 166 hypoplasia, 66, 147 foreign body, 13, 149, 167–168 isthmus, 86 rhabdomyosarcoma, 7, 60–61, 168, 210, 218, 220–221 junctional zone, 205 Vaginography, 13 leiomyoma, 204–205 Van Wyk-Grumbach syndrome, 116, 139 length, 94, 97 VCUAM Classification, 67–68 lipoleiomyoma, 204 Vestibular glands, 29–30 neonatal, 3–5, 167 Vestigial remnants of the , 29–30 retroversion, 87 Virilisation, 130, 138, 140, 215 septate, 72–73 Virilising tumour (see also Adrenocortical tumour), 160, 162 shape, 97 ultrasound appearances at puberty, 86 ultrasound appearances in infancy, 86, 92 W ultrasound appearances in infancy Wegener’s granulomatosis, 148 prepubertal child, 86, 93 Weight-loss, 148–149 unicornuate, 68, 74 William’s syndrome, 118 volume, 6, 11 Wilm’s tumour screening, 39 zonal anatomy on MR (also see Menstrual cycle—MR WNT4 deficiency, 75 imaging of endometrium), 104 Wolffian duct (see also ), 33–34, 40 Utero- (see ovarian ligament), 34 Wolffian vestiges, 30 , 24–25

X V X-chromosome, 22, 33 VACTERL association, 58 XX , 119, 127, 129 Vagina anatomy, 84–85 atresia (agenesis), 56, 68, 149, 185 Y duplication, 68, 78 Y-chromosome, 22, 33 hypoplasia, 78, 185