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76 Cards in this Set

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Name 3 functions of the ovary

1. mature oocytes for ovulation


2. synthesize androgens and convert them to estrogens


3. produce progesterone after ovulation to sustain early pregnancy.

Name 4 functional cyst

1. Follicular


2. Corpus Luteum


3. Hemorrhagic


4. Theca-Lutein Cysts

What is the formula for calculating ovarian volume?

Length x Width x Height x 0.523

Would an ovarian volume of 10cc be considered abnormal for a postmenopausal patient?

Yes, above 8cc is considered abnormal

While performing an exam on a 28 year old patient, you note the ovarian volume of the right ovary is 11cc and the volume of the left ovary is 18cc.


Is this considered abnormal?

No, the volume of more than TWICE that of opposite side is considered abnormal.

Which of the functional cysts appears simple?

Follicular

Which of the functional cysts are most likely to be unilateral? Bilateral?

Unilateral: Follicular, corpus luteal, hemorrhagic




Bilateral: Theca-lutein

Which of the functional cysts is most likely to mimic a solid lesion?

Hemorrhagic

What hormone is secreted by theca-lutein cysts?

None

Sonographic and clinical follow up is recommended for cysts measuring greater than _______.

3 cm

What syndrome is the result of an iatrogenic complication?

Ovarian Hyperstimulation Syndrome

What 2 hormones are imbalanced in PCOS?

LH and FSH

T or F: Diffuse endometriosis is easily detected on ultrasound?

False

What measurements are used a guidelines for mild vs. severe ovarian stimulation?

Mild: < 5 cm


Severe: > 10 cm

What is PCOS?

- Chronic an ovulation


- Several follicles begin development but do not ovulate due to hormone imbalance. `

What is your conclusion of this image?



What is your conclusion of this image?

Severe form of Ovarian Hyperstimulation Syndrome

What clinical findings is this patient likely to have?

What clinical findings is this patient likely to have?

1. Amenorrhea


2. Obesity


3. Infertility


4. Hirsutism

Differentiate endometriosis from adenomyosis:

Endometriosis: Ectopic tissue can be found almost anywhere in the pelvis, including ovary, fallopian tube, broad ligament, external surface of uterus, scattered over peritoneum, cul-de-sac, and bladder.




Adenomyosis: endometrial tissue invades and implants within myometrium.

What is an ovarian torsion?

A partial or complete rotation of ovarian pedicle on its axis, compromising lymphatic and venous drainage.

What are characteristics of a complex mass?

- Any simple cyst that hemorrhages as it involutes may appear as a complex mass.

What are characteristics of a solid mass?

- More monographically complex


- The tumor is more likely to be malignant (especially if associated with ascites)

What type of patients are affected by complex masses?

Patients of reproductive age

What type of patients are typically affected by solid masses?

1. Patients during peak fertile years (Only 1 in 15 are malignant)


- The ratio becomes 1 in 3 after age 40.



Considerations for complex masses:


1. ectopic pregnancy


2. Endometriosis


3. Pelvic Inflammatory Disease


4. Dermoids/Benign tumors

Considerations for solid masses:

1. connection with uterus to differentiate ovarian lesion from pedunculated fibroid.


2. color doppler can determine between mass and uterus

More likely to be benign or malignant?


Unilocular vs. Multilocular

unilocular = Benign

Multilocular = Malignant



Benign or Malignant? Thick or Thin septations

Thin = Benign


Thick = Malignant

Benign or Malignant? Enlarged Echogenic Ovaries

Malignant

Benign or Malignant? Well defined anechoic lesions

Benign

Benign or Malignant? Any change in ovarian echogenicity or volume of more than 20 ml.

Malignant

Benign or Malignant? Masses > 10 cm

Malignant

Benign or Malignant? Extension beyond ovary into omentum or peritoneum and liver metastases

Malignant

Benign or Malignant? Lesions with irregular walls

Malignant

Benign or Malignant? Wall or septal thickness > 3 mm

Malignant

Benign or Malignant? Masses < 5 cm

Benign

What type of cyst is this an image of? 

What type of cyst is this an image of?

A simple cyst

What are the arrows pointing to? 

What are the arrows pointing to?

Papillary projections

What is this an image of? 

What is this an image of?

An endometrioma

What is this an image of? 

What is this an image of?

Dermoid Plug

Is this unilocular or multilocular? 

Thick or thin septations? 

Is this unilocular or multilocular?




Thick or thin septations?

Multilocular with thick septations

A patient in her 15th week of pregnancycame to the clinician with size larger than dates. The ultrasound examinationshowed an enlarged uteruscompletely filled with grapelike clusters.What finding may the sonographer notice whenscanning the ovaries?
1. Enlargeduterus with grapelike clusters (Gestational Trophic Disease Ovaries)

2. Theca-lutein cysts

Where are paraovarian cysts located?

In the broad ligament

What is "Meigs Syndrome"

theassociation of ascites and pleural effusion with a fibrous ovarian tumor (mostcommonly a fibroma) that disappears after excision of the tumor.
What hormone is elevated in this condition? 

What hormone is elevated in this condition?



hCG

What are the arrows pointing to? 

What are the arrows pointing to?

Gestational Trophoblastic Disease

What is this? 

What is this?

Theca Lutein Cysts

Does the following image appear more cystic or solid? 

Does the following image appear more cystic or solid?

Cystic because of posterior enhancement

What is this an image of? 

What is this an image of?

Ovarian Torsion

Which type of teratomais malignant?



mature or immature?

Immature

What is this person suffering from? 

What is this person suffering from?

PCOS

Aside from PCOS, what is this disease known as? 

Aside from PCOS, what is this disease known as?

The String of Pearls

A thecoma,fibroma, and granulosa are what type of tumor?

Sex cord stromal tumors

What areas should be evaluated in thecase of a suspicious ovarian mass?
1. Peritoneum(for ascites and mets)

2. Lymphnodes


3. Liver


4. Pleuralspace

What procedure is being performed in this image?       
What procedure is being performed in this image?

Ultrasound guided needle aspiration

What type of cyst is in this image? 

What type of cyst is in this image?

Hemorrhagic Cyst

What type of cyst is in this image? 

What type of cyst is in this image?

Theca Lutein Cyst

Theca Lutein cyst have high levels of _____, which result from overstimulation during infertility treatment.

hCG

What is this an image of? 

What is this an image of?

Ovarian Hyperstimulation Syndrome

This is a sideffect of which disease? 

This is a sideffect of which disease?

Polycystic Ovarian Syndrome

Endometriosis can implant where? 

Endometriosis can implant where?

Almostanywhere in pelvis; including ovary, fallopian tube, broad ligament, externalsurface of uterus, scattered over peritoneum, cul-de-sac & bladder
Which cystic mass is this? 
- 










Containing diffuse homogeneous, low-level
internal echoes 






- 










Predominantly cystic mass

Which cystic mass is this?


- Containing diffuse homogeneous, low-levelinternal echoes


- Predominantly cystic mass

Endometrioma

What is this known as? 
What is the clinical term? 

What is this known as?


What is the clinical term?

"Chocolate Cyst"


The clinical terms is Endometrioma.

What is this diagram demonstrating? 

What is this diagram demonstrating?

Ovarian Torsion

What tool is this demonstrating? 
What is this known as? 

What tool is this demonstrating?


What is this known as?

> Color doppler




> Whirlpool sign to help identify ovarian torsion

What is the name of this tumor and what organ is it associated with? 

What is the name of this tumor and what organ is it associated with?

> Krukenberg Tumor




> Pancreatic Carcinoma

Is this an image of bilateral or unilateral ovarian carcinoma? 

Is this an image of bilateral or unilateral ovarian carcinoma?

Bilateral Metastasis

What carcinoma is known as looking "sausage shaped"? 

What carcinoma is known as looking "sausage shaped"?

Fallopian Tube Carcinoma

This is an image of Serous Cystadenoma, is it typically unilateral or bilateral? 
Unilocular or Mulilocular? 

This is an image of Serous Cystadenoma, is it typically unilateral or bilateral?


Unilocular or Mulilocular?

> Unilateral




> Multilocular

Is this an image of Serous Cystadenoma or Serous Cystadenocarcinoma? 

Is this an image of Serous Cystadenoma or Serous Cystadenocarcinoma?

Serous Cystadenocarcinoma

______ cyst can contain hair, cartilage, bone & teeth                  
______ cyst can contain hair, cartilage, bone & teeth

Dermoid

What is this image known as? 

What is this image known as?

"Tip of the iceberg"

This is known as a dermoid ______. 

This is known as a dermoid ______.

mesh

Numerous Intracystic
Floating Balls as a Sonographic Feature of Benign Cystic Teratoma called _________. 
Numerous IntracysticFloating Balls as a Sonographic Feature of Benign Cystic Teratoma called _________.

A dermoid tumor

This mass is rare, malignant, occurs in women <30 yrs old & commonly seen in pregnancy is known as _______.

This mass is rare, malignant, occurs in women <30 yrs old & commonly seen in pregnancy is known as _______.

Dysgerminoma

A 46-year-old woman was found to have a
grapefruit-sized mass on pelvic examination. Sonography showed a well-defined,
homogenous mass in the right ovary, which was surgically removed. This mass is known as ________  
A 46-year-old woman was found to have agrapefruit-sized mass on pelvic examination. Sonography showed a well-defined,homogenous mass in the right ovary, which was surgically removed. This mass is known as ________

Granulosa

This is known as ______ 

This is known as ______

Pelvic Kidney