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Obstetric Gynecologic Radiology OB001-EB-X MRI Virtual Hysterosalpingography: How to Do It?

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Obstetric Gynecologic Radiology OB001-EB-X MRI Virtual Hysterosalpingography: How to Do It? Obstetric Gynecologic Radiology OB001-EB-X MRI Virtual Hysterosalpingography: How to do it? All Day Room: OB Community, Learning Center Participants Patricia M. Carrascosa, MD, Buenos Aires, Argentina (Presenter) Research Consultant, General Electric Company Jimena B. Carpio, MD, Buenos Aires, Argentina (Abstract Co-Author) Nothing to Disclose Javier Vallejos, MD, Vicente Lopez, Argentina (Abstract Co-Author) Nothing to Disclose Carlos Capunay, MD, Buenos Aires, Argentina (Abstract Co-Author) Nothing to Disclose TEACHING POINTS To describe a novel radiation free imaging modality for integral the evaluation of the female pelvis.To be familiar with the advantages, disadvantages, normal anatomy, pathological findings and pitfalls of MRI virtual hysterosalpingography. TABLE OF CONTENTS/OUTLINE A. Description of the procedure. Patient preparation B. MRI image acquisition. Technical parameters. C. Contrast injection protocol. D. Image post-processing and Interpretation E. Diagnostic Imaging F. Indications G. Outcomes OB002-EB-X Common and Uncommon Imaging Presentations of Ectopic Pregnancy All Day Room: OB Community, Learning Center Participants Kellan Schallert, MD, Charlottesville, VA (Presenter) Nothing to Disclose Gia A. Deangelis, MD, Charlottesville, VA (Abstract Co-Author) Nothing to Disclose Arun Krishnaraj, MD, MPH, Charlottesville, VA (Abstract Co-Author) Nothing to Disclose TEACHING POINTS Illustrate the imaging features of various locations and appearances of ectopic pregnancies Highlight classic features, features which portend a poor prognosis, and unique locations of ectopic pregnancies Brief review of the management options TABLE OF CONTENTS/OUTLINE Common and Uncommon Imaging Presentations of Ectopic PregnancyTeaching Points Illustrate the imaging features of various locations and appearances of ectopic pregnancy Highlight classic features, features which portend a poor prognosis, and unique locations of ectopic pregnancies Brief review of the management optionsOutline1. A review of the imaging features of various ectopic pregnancies Tubal ectopic Interstitial ectopic Cervical ectopic C-section scar ectopic Heterotopic ectopic Unicornuate uterus with an ectopic (cornual) pregnancy in a non-communicating rudimentary uterine horn2. Highlight the classic features as well as features which portend a poor prognosis3. Brief review of the typical management options including surgical, medical therapy, sac injection, and uterine artery embolization which may be combined with medical or surgical therapy to decrease bleeding OB003-EB-X Imaging Features of Gestational Trophoblastic Disease All Day Room: OB Community, Learning Center Participants Christopher T. Harms, MD, Tucson, AZ (Presenter) Nothing to Disclose Bobby T. Kalb, MD, Tucson, AZ (Abstract Co-Author) Nothing to Disclose Diego R. Martin, MD, PhD, Tucson, AZ (Abstract Co-Author) Nothing to Disclose Ferenc Czeyda-Pommersheim, MD, Pittsburgh, PA (Abstract Co-Author) Nothing to Disclose Iva Petkovska, MD, Tucson, AZ (Abstract Co-Author) Nothing to Disclose Hina Arif, Vancouver, BC (Abstract Co-Author) Nothing to Disclose James R. Costello, MD, PhD, Tucson, AZ (Abstract Co-Author) Nothing to Disclose TEACHING POINTS Gestational trophoblastic disease (GTD) represents a spectrum of trophoblastic tissue proliferative disorders comprising relatively benign expressions such as hydatidiform mole and more malignant variants such as invasive mole, placental site trophoblastic tumor, and choriocarcinoma. These tumors affect roughly 1:1000 pregnancies with the incidence of hydatidiform mole estimated at 0.57- 1.1 per 1000 pregnancies. Frequently, the time course of the disease is followed with serial quantitative levels of human chorionic gonadotropin (HCG), but a complete imaging evaluation is critically important for patient management. This exhibit details Magnetic Resonance Imaging (MRI) features in the diagnosis of GTD while offering a review of the associated ultrasonic (US) and computed tomography (CT) findings. TABLE OF CONTENTS/OUTLINE Table of Contents/Outline:- Pathology of GTD- Clinical Course of GTD- Ultrasound features of GTD- CT features of GTD- MRI safety for a pregnant patient OB006-EB-X MR Evaluation of the Placenta From Normal Variants to Abnormalities of Implantation and Malignancies. A Pictorial Review All Day Room: OB Community, Learning Center Participants Arwa A. Alzaghal, MD, Beirut, Lebanon (Presenter) Nothing to Disclose Lara Nassar, MD, FRCR, Beirut, Lebanon (Abstract Co-Author) Nothing to Disclose Hero K. Hussain, MD, Ann Arbor, MI (Abstract Co-Author) Nothing to Disclose Ghina A. Berjawi, MD, Beirut, Lebanon (Abstract Co-Author) Nothing to Disclose TEACHING POINTS The purpose of this educational exhibit is to: Identify the role of MR in evaluating the placenta. Describe the MRI protocol/technique used for evaluating the placenta. Review the normal appearance of the placenta and its variants. Describe the clinical features and imaging findings of major placental abnormalities related to position and depth of implantation, placental hemorrhage, and gestational trophoblastic disease. Discuss the added value of MRI in the management and preoperative planning of such abnormalities. TABLE OF CONTENTS/OUTLINE Introduction. Role of MRI in evaluation of the placenta antenatally. MRI technique for imaging the placenta. MR imaging appearance of the normal placenta and its variants. MR imaging appearance of major placental abnormalities: Abnormalities of position of implantation (placenta previa). Abnormalities of depth of implantation and adherence (placenta accreta, increta and percreta) Placental hemorrhage (placental hematoma, abruptio). Gestational trophoblastic disease. Retained products of conception and arteriovenous fistulae Role of MR imaging in the management and preoperative planning of placental abnormalities. Conclusion. OB100-ED-X Signs in Fetal MR Imaging: Correlation with Ultrasonography and Postnatal Imaging All Day Room: OB Community, Learning Center Participants Keiko Segawa, Nagasaki, Japan (Presenter) Nothing to Disclose Atsushi Segawa, Nagasaki, Japan (Abstract Co-Author) Nothing to Disclose Minoru Morikawa, MD, Nagasaki, Japan (Abstract Co-Author) Nothing to Disclose Masataka Uetani, MD, Nagasaki, Japan (Abstract Co-Author) Nothing to Disclose TEACHING POINTS To review signs in fetal MR imaging for the diagnosis of various congenital abnormalities, which are correlated with imaging findings of ultrasonography and postnatal study To demonstrate illustrative cases To understand how useful the imaging signs to prenatal diagnosis TABLE OF CONTENTS/OUTLINE Category of the signs CNS Gastrointestinal Urogenital Liver and biliary tract Chest Multifetal OB101-ED-X Multimodality Imaging of Endometrial Ablation All Day Room: OB Community, Learning Center Participants Monica R. Drylewicz, MD, PhD, Saint Louis, MO (Presenter) Nothing to Disclose Cary L. Siegel, MD, Saint Louis, MO (Abstract Co-Author) Nothing to Disclose Kathryn A. Robinson, MD, Saint Louis, MO (Abstract Co-Author) Nothing to Disclose TEACHING POINTS 1. To obtain a basic understanding of endometrial ablation indications and procedures.2. To learn to recognize the normal appearance of the post-endometrial ablation uterus on multiple imaging modalities.3. To demonstrate common and uncommon complications seen on imaging post endometrial ablation. TABLE OF CONTENTS/OUTLINE Endometrial ablation indications and methodsNormal post-procedural appearance on ultrasound, CT, MRI, HSGPossible complications as imaged with ultrasound, CT, MRI OB108-ED-X Ovarian Mucinous Tumors: Usual, Unusual Imaging Manifestations, Differential Diagnosis and Pitfalls All Day Room: OB Community, Learning Center Participants Mayumi Takeuchi, MD, PhD, Tokushima, Japan (Presenter) Nothing to Disclose Kenji Matsuzaki, MD, PhD, Tokushima, Japan (Abstract Co-Author) Nothing to Disclose Masafumi Harada, MD, PhD, Tokushima, Japan (Abstract Co-Author) Nothing to Disclose TEACHING POINTS 1. Because mucinous ovarian tumors have lower response to chemotherapy and aggressive cytoreductive surgery is required to improve the prognosis, correct preoperative diagnosis based on imaging is important. To distinguish primary and secondary mucinous tumors is necessary for the adequate treatment strategy. 2. We demonstrate various clinical and imaging manifestations of primary and secondary ovarian mucinous tumors according to WHO 2014 classification, and describe the technical challenges and advantages of advanced MR techniques (DWI, computed DWI, reduced FOV DWI, SWI, DCE-MRI, MRS) for the diagnosis. 3. Mucin origin high N-acetyl mucinous compounds peak on MRS is specific for mucinous tumors. TABLE OF CONTENTS/OUTLINE Etiology, clinical features and therapeutic strategy -Primary: Mucinous tumors; Seromucinous tumors -Secondary: Gastric cancer (Krukenberg tumor); Colon cancer; Others Characteristic imaging features with pathologic correlation: Stained-glass appearance (cystadenoma); Aggregated tiny loculi (borderline malignancy); Black sponge-like appearance (adenofibroma); Organic scalloping (pseudomyxoma) Co-existing tumors: Teratoma; Brenner tumor; Carcinoid Complications and Paraneoplastic syndrome: Pseudomyxoma peritonei; Estrogenic symptom; Pseudo-Meigs’ syndrome Mimickers and clues for the differential diagnosis OB109-ED-X Diagnostic Impact of Susceptibility-weighted MR Sequences in the Female Pelvis All Day Room: OB Community, Learning Center Participants Mayumi Takeuchi, MD, PhD, Tokushima, Japan (Presenter) Nothing to
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