Ultrasound Assessment of Acute Female Pelvic Pain of Ovarian Origin: Pictorial Essay and Brief Review
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Abstract
Ultrasound is the initial imaging modality in evaluating ovarian pathology in women in a fertile state, establishing the diagnosis in most cases and without exposing them to large doses of ionizing radiation. In this article, we will describe the imaging findings of the main ovarian pathologies that generate pelvic pain and that are a reason for admission to the emergency room, as well as a brief review of each topic.
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References
I. Rivera Domínguez, A., Mora Jurado, A., García de la Oliva, A., de Araujo Martins-Romeo, D., & Cueto Álvarez, L. (2017). Dolor pélvico de origen ginecológico como patología urgente. Radiología, 59(2),115-127. https://doi.org/10.1016/j.rx.2016.09.010
II. Kaproth-Joslin, K., Sidhu, R., Bhatt, S., Voci, S., Fultz, P., Dogra, V., & Rubens, D. (2014). Resident and Fellow Education Feature: US Assessment of Acute Female Pelvic Pain: Test Your Knowledge. RadioGraphics, 34(5), 1440-1441.
https://doi.org/10.1148/rg.345130135
III. Johnson, N. P., Hummelshoj, L., Adamson, G. D., Keckstein, J., Taylor, H. S., Abrao, M. S., Bush, D., Kiesel, L., Tamimi, R., Sharpe-Timms, K. L., Rombauts, L., & Giudice, L. C. (2017). World Endometriosis Society consensus on the classification of endometriosis. Human Reproduction, 32(2), 315-324.
https://doi.org/10.1093/humrep/dew293
IV. Hoyle, A. T., & Puckett, Y. (2022). Endometrioma. En StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK559230/
V. Falcone, T., & Flyckt, R. (2018). Clinical Management of Endometriosis. Obstetrics & Gynecology, 131(3), 557-571.
https://doi.org/10.1097/AOG.0000000000002469
VI. Cranney, R., Condous, G., & Reid, S. (2017). An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. Acta Obstetricia et Gynecologica Scandinavica, 96(6), 633-643.https://doi.org/10.1111/aogs.13114
VII. Guerriero, S., Condous, G., van den Bosch, T., Valentin, L., Leone, F. P. G. et al. (2016). A systematic approach to the sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions, and measurements: A consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound in Obstetrics & Gynecology, 48(3), 318-332. https://doi.org/10.1002/uog.15955
VIII. Kiesel, L., & Sourouni, M. (2019). Diagnosis of endometriosis in the 21st century. Climacteric, 22(3), 296-302.
https://doi.org/10.1080/13697137.2019.1578743
IX. Guile, S. L., & Mathai, J. K. (2022). Ovarian Torsion. En StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK560675/
X. Dasgupta, R., Renaud, E., Goldin, A. B., Baird, R., Cameron, D. B., et al. (2018). Ovarian torsion in pediatric and adolescent patients: A systematic review. Journal of Pediatric Surgery, 53(7), 1387–1391. https://doi.org/10.1016/j.jpedsurg.2017.10.053
XI. Childress, K. J., & Dietrich, J. E. (2017). Pediatric Ovarian Torsion. Surgical Clinics of North America, 97(1), 209-221.
https://doi.org/10.1016/j.suc.2016.08.008
XII. Huang, C., Hong, M.-K., & Ding, D.-C. (2017). A review of ovary torsion. Tzu Chi Medical Journal, 29(3), 143.
https://doi.org/10.4103/tcmj.tcmj_55_17
XIII. Bottomley, C., & Bourne, T. (2009). Diagnosis and management of ovarian cyst accidents. Best Practice & Research Clinical Obstetrics & Gynaecology, 23(5), 711-724.
https://doi.org/10.1016/j.bpobgyn.2009.02.001
XIV. McWilliams, G. D. E., Hill, M. J., & Dietrich, C. S. (2008). Gynecologic Emergencies. Surgical Clinics of North America, 88(2), 265-283.
https://doi.org/10.1016/j.suc.2007.12.007
XV. Sintim-Damoa, A., Majmudar, A. S., Cohen, H. L., & Parvey, L. S. (2017). Pediatric Ovarian Torsion: Spectrum of Imaging Findings. RadioGraphics, 37(6), 1892–1908.
https://doi.org/10.1148/rg.2017170026
XVI. Bottomley, C., & Bourne, T. (2009). Diagnosis and management of ovarian cyst accidents. Best Practice & Research Clinical Obstetrics & Gynaecology, 23(5), 711–724.
https://doi.org/10.1016/j.bpobgyn.2009.02.001
XVII. McWilliams, G. D. E., Hill, M. J., & Dietrich, C. S. (2008). Gynecologic Emergencies. Surgical Clinics of North America, 88(2), 265–283. https://doi.org/10.1016/j.suc.2007.12.007
XVIII. Bass, I. S., Haller, J. O., Friedman, A. P., Twersky, J., Balsam, D., & Gottesman, R. (1984). The sonographic appearance of the hemorrhagic ovarian cyst in adolescents. Journal of Ultrasound in Medicine, 3(11), 509–513.
https://doi.org/10.7863/jum.1984.3.11.509
XIX. Xiang, H., Han, J., Ridley, W. E., & Ridley, L. J. (2018). Fishnet/cobweb ovary: Haemorrhagic ovarian cyst. Journal of Medical Imaging and Radiation Oncology, 62, 77–77.
https://doi.org/10.1111/1754-9485.25_12784
XX. Yoffe, N., Bronshtein, M., Brandes, J., & Blumenfeld, Z. (1991). Hemorrhagic ovarian cyst detection by transvaginal sonography: The great imitator. Gynecological Endocrinology, 5(2), 123–129. https://doi.org/10.3109/09513599109028435
XXI. Andrade, A. G., Rocha, S., Marques, C. O., Simões, M., Martins, I., Biscaia, I., & F. Barros, C. (2015). Ovarian ectopic pregnancy in adolescence. Clinical Case Reports, 3(11), 912–915.
https://doi.org/10.1002/ccr3.336
XXII. Goyal, L. D., Tondon, R., Goel, P., & Sehgal, A. (2014). Ovarian ectopic pregnancy: A 10 years’ experience and review of the literature. Iranian Journal of Reproductive Medicine, 12(12), 825–830.
XXIII. Joseph, R. J., & Irvine, L. M. (2012). Ovarian ectopic pregnancy: Aetiology, diagnosis, and challenges in surgical management. Journal of Obstetrics and Gynaecology, 32(5), 472–474. https://doi.org/10.3109/01443615.2012.673039
XXIV. Seo, M. R., Choi, J. S., Bae, J., Lee, W. M., Eom, J. M., Lee, E., & Keum, J. (2017). Preoperative diagnostic clues to ovarian pregnancy: A retrospective chart review of women with ovarian and tubal pregnancy. Obstetrics & Gynecology Science, 60(5), 462.
https://doi.org/10.5468/ogs.2017.60.5.462
XXV. Condous, G. (2007). Ultrasound Diagnosis of Ectopic Pregnancy. Seminars in Reproductive Medicine, 25(2), 085–091.
https://doi.org/10.1055/s-2007-970047
XXVI. Nadim, B., Infante, F., Lu, C., Sathasivam, N., & Condous, G. (2018). Morphological ultrasound types are n as ‘blob’ and ‘bagel’ signs should be reclassified from suggesting probable to indicating definite tubal ectopic pregnancy. Ultrasound in Obstetrics & Gynecology, 51(4), 543–549. https://doi.org/10.1002/uog.17435
XXVII. Franco, J. G., Baruffi, R. L. R., Mauri, A. L., Petersen, C. G., & Oliveira, J. B. A. (1994). Infertility: Ovarian synchrony factor: a new ultrasound parameter in the prognosis of follicular rupture. Human Reproduction, 9(7), 1250–1252. https://doi.org/10.1093/oxfordjournals.humrep.a138688
XXVIII. Potočnik, B., Cigale, B., & Zazula, D. (2012). Computerized detection and recognition of follicles in ovarian ultrasound images: A review. Medical & Biological Engineering & Computing, 50(12), 1201–1212. https://doi.org/10.1007/s11517-012-0956-y
XXIX. Coelho Neto, M. A., Ludwin, A., Borrell, A., Benacerraf, B., Dewailly, D., da Silva Costa, F., Condous, G., Alcazar, J. L., Jokubkiene, L., Guerriero, S., Van den Bosch, T., & Martins, W. P. (2018). Counting ovarian antral follicles by ultrasound: A practical guide: Consensus Opinion. Ultrasound in Obstetrics & Gynecology, 51(1), 10–20. https://doi.org/10.1002/uog.18945
XXX. Re, C., Mignini Renzini, M., Rodriguez, A., Dal Canto, M., Buccheri, M., Sacchi, S., Bartolucci, S., Fadini, R., & La Marca, A. (2019). From a circle to a sphere: The ultrasound imaging of ovarian follicle with 2D and 3D technology. Gynecological Endocrinology, 35(3), 184–189.
https://doi.org/10.1080/09513590.2018.1522297
XXXI. Pfeifer, S., Butts, S., Dumesic, D., Fossum, G., Gracia, C., La Barbera, A., Mersereau, J., Odem, R., Paulson, R., Penzias, A., Pisarska, M., Rebar, R., Reindollar, R., Rosen, M., Sandlow, J., Vernon, M., & Widra, E. (2016). Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: A guideline. Fertility and Sterility, 106(7), 1634–1647.
https://doi.org/10.1016/j.fertnstert.2016.08.048
XXXII. Blumenfeld, Z. (2018). The Ovarian Hyperstimulation Syndrome. In Vitamins and Hormones (Vol. 107, pp. 423–451). Elsevier. https://doi.org/10.1016/bs.vh.2018.01.018
XXXIII. Nastri, C. O., Teixeira, D. M., Moroni, R. M., Leitão, V. M. S., & Martins, W. P. (2015). Ovarian hyperstimulation syndrome: Pathophysiology, staging, prediction, and prevention: Pathophysiology, staging, prediction, and prevention of OHSS. Ultrasound in Obstetrics & Gynecology, 45(4), 377–393.
https://doi.org/10.1002/uog.14684
XXXIV. Nelson, S. M. (2017). Prevention and management of ovarian hyperstimulation syndrome. Thrombosis Research, 151, S61–S64.
https://doi.org/10.1016/S0049-3848(17)30070-1
XXXV. Bellapu, S., & Guttman, J. (2017). Use of Point-of-Care Ultrasound for the Diagnosis of Ovarian Hyperstimulation Syndrome. The Journal of Emergency Medicine, 52(4), e101–e104. https://doi.org/10.1016/j.jemermed.2016.11.026
XXXVI. Martins, W. P., Vieira, C. V. R., Teixeira, D. M., Barbosa, M. A. P., Dassunção, L. A., & Nastri, C. O. (2014). Ultrasound for monitoring controlled ovarian stimulation: A systematic review and meta-analysis of randomized controlled trials: Monitoring controlled ovarian stimulation. Ultrasound in Obstetrics & Gynecology, 43(1), 25–33.
https://doi.org/10.1002/uog.12566
XXXVII. Alotaibi, M. O. S., & Navarro, O. M. (2010). Imaging of Ovarian Teratomas in Children: A 9-Year Review. Canadian Association of Radiologists Journal, 61(1), 23–28.
https://doi.org/10.1016/j.carj.2009.07.001
XXXVIII. Saba, L., Guerriero, S., Sulcis, R., Virgilio, B., Melis, G., & Mallarini, G. (2009). Mature and immature ovarian teratomas: CT, US, and MR imaging characteristics. European Journal of Radiology, 72(3), 454–463. https://doi.org/10.1016/j.ejrad.2008.07.044
XXXIX. Saleh, M., Bhosale, P., Menias, C. O., Ramalingam, P., Jensen, C., Iyer, R., & Ganeshan, D. (2021). Ovarian teratomas: Clinical features, imaging findings, and management. Abdominal Radiology, 46(6), 2293–2307. https://doi.org/10.1007/s00261-020-02873-0
XL. Saida, T., Mori, K., Masumoto, T., Hoshiai, S., Ishiguro, T., Sakai, M., Hara, T., Ochi, H., Satoh, T., & Minami, M. (2021). Ovarian and non-ovarian teratomas: A wide spectrum of features. Japanese Journal of Radiology, 39(2), 143–158. https://doi.org/10.1007/s11604-020-01035-y