Gynecologic Imaging - 1st Edition

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Contributors

Lejla Aganovic, MD Douglas L. Brown, MD

Assistant Professor Professor of Radiology
Department of Radiology Department of Radiology
University of California Mayo Clinic College of Medicine
San Diego, California Rochester, Minnesota
Computed Tomography: Normal Anatomy, Imaging Pelvic Pain: Lower Urinary Tract—Urethral
Techniques, and Pitfalls Diverticulum, Cysts, and Varix
Uterine Leiomyomas
Paula Amato, MD Approach to Imaging the Adnexal Mass
Associate Professor
Department of Obstetrics and Gynecology Lauren M. Brubaker, MD
Oregon Health and Science University Resident Physician
Portland, Oregon Department of Radiology
Infertility, Evaluation, and Treatment University of North Carolina Hospitals
University of North Carolina at Chapel Hill
Rochelle F. Andreotti, MD Chapel Hill, North Caroliina
Professor of Clinical Radiology and Radiology Sciences Hysterosalpingography: Techniques, Normal Anatomy,
Department of Radiology and Pitfalls
Associate Professor of Clinical Obstetrics and Gynecology
Department of Obstetrics and Gynecology Lara Lyn Bryan-Rest, MD
Vanderbilt University Medical Center Department of Diagnostic Radiology
Nashville,Tennessee Yale–New Haven Hospital
Approach to Pelvic Pain and the Role of Imaging New Haven, Connecticut
Ectopic Pregnancy
Mostafa Atri, MD, Dipl Epid
Head Richard L. Clark, MD
Section of Ultrasound Emeritus Professor of Radiology
Joint Department of Medical Imaging Department of Radiology
Head University of North Carolina School of Medicine
Division of the Abdomen Chapel Hill, North Carolina
Medical Imaging Department Hysterosalpingography: Techniques, Normal Anatomy,
Toronto University and Pitfalls
Professor of Radiology
University of Toronto Harris L. Cohen, MD
Toronto, Ontario, Canada Chair and Professor of Radiology, Pediatrics,
Malignant Ovarian Masses and Obstetrics and Gynecology
Department of Radiology
Deborah A. Baumgarten, MD, MPH University of Tennessee
Associate Professor Medical Director
Department of Radiology
Emory University
Atlanta, Georgia
Benign Endometrial Causes of Abnormal Bleeding

v
vi Contributors

Department of Radiology Sara Durfee, MD

LeBonheur Children’s Medical Center Assistant Professor
Memphis,Tennessee Department of Radiology
Emeritus Professor of Radiology Harvard Medical School
Stony Brook School of Medicine Associate Radiologist
Stony Brook, New York Department of Radiology
Gynecologic Imaging of the Pediatric Patient Brigham and Women’s Hospital
Boston, Massachusetts
Carlos Cuevas, MD Retained Products of Conception
Assistant Professor
Department of Radiology Steven C. Eberhardt, MD
University of Washington Associate Professor
Director Department of Radiology
Gastronterology Radiology University of New Mexico
Department of Radiology Albuquerque, New Mexico
University of Washington Medical Center Ovarian and Fallopian Tube Cancer
Seattle, Washington
Chronic Pelvic Pain Fiona M. Fennessy, MD, PhD
Assistant Professor of Radiology
Roberta diFlorio-Alexander, MD Department of Radiology
Assistant Professor Harvard Medical School
Radiology and Obstetrics and Gynecology Assistant Professor of Radiology
Dartmouth Medical School Department of Radiology
Hanover, New Hampshire Brigham and Women’s Hospital
Postpartum Complications Boston, Massachusetts
Magnetic Resonance–Guided Ultrasound Surgery
Manjiri Dighe, MD of€Uterine Leiomyomas
Assistant Professor
Department of Radiology Julia R. Fielding, MD
University of Washington Medical Center Professor of Radiology
Seattle, Washington Division Chief of Abdominal Imaging
Acute Pelvic Pain Department of Radiology
Chronic Pelvic Pain University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Vikram Dogra, MD Magnetic Resonance Imaging of the Female Pelvis:
Professor of Radiology Technique, Anatomy, and Pitfalls
Urology and BME Imaging of Pelvic Floor Dysfunction
Department of Imaging Science
University of Rochester Medical Center Maureen S. Filipek, MD
Rochester, New York Radiologist
The Normal Pelvis on Ultrasound Imaging Women’s Imaging
and Anatomic Correlations EPIC Imaging West
Beaverton, Oregon
Peter M. Doubilet, MD, PhD Gestational Trophoblastic Neoplasia
Professor of Radiology Uterine Cancers
Harvard Medical School
Senior Vice Chair of Radiology Jurgen J. Fütterer, MD, PhD
Brigham and Women’s Hospital Radiologist
Boston, Massachusetts Department of Radiology
Ultrasound-Guided Treatment of Ectopic Pregnancy Radboud University Nijmegen Medical Centre
Nijmegen,The Netherlands
Theodore Dubinsky, MD, FSRU Diffusion Magnetic Resonance Imaging
Larry Mack Professor of Radiology, Obstetrics,
Gynecology, and Reproductive Health Sciences Margaret L. Gallegos, BS, MD
Director of Body Imaging Resident
Department of Radiology Department of Radiology
University of Washington School of Medicine University of New Mexico
Seattle, Washington Albuquerque, New Mexico
Chronic Pelvic Pain Ovarian and Fallopian Tube Cancer
 Contributors vii

Nancy Hammond, MD Golbahar Houshmand, MD

Assistant Professor of Radiology Research fellow
Department of Radiology Department of Radiology
Feinberg School of Medicine University of Pittsburgh Medical Center
Northwestern University Pittsburgh, Pennsylvania
Chicago, Illinois Müllerian Uterine Anomalies
Uterine Artery Embolization
Lynne M. Hurwitz, MD
Robert D. Harris, MD, MPH Associate Professor
Co-Director of Ultrasound (Education and Research) Department of Radiology
Department of Radiology Duke University Medical Center
Dartmouth Medical School Durham, North Carolina
Lebanon, New Hampshire Dose Reduction Techniques in Multidetector Computed
Professor of Radiology and Obstetrics and Gynecology Tomography Body Imaging
Dartmouth-Hitchcock Medical Center
Hannover, New Hampshire Tracy A. Jaffe, MD
Postpartum Complications Associate Professor of Radiology
Department of Radiology
David S. Hartman, MD Duke University Medical Center
Professor of Radiology Durham, North Carolina
Department of Radiology Dose Reduction Techniques in Multidetector Computed
The Pennsylvania State College of Medicine Tomography Body Imaging
Professor of Radiology
Department of Radiology Keith C. Kaplan, MD, MS
Milton S. Hershey Medical Center Resident Physician
Hershey, Pennsylvania Department of Radiology
The Imaging of Contraception The Pennsylvania State College of Medicine
Resident Physician
Sara M. Harvey, MD Department of Radiology
Instructor Milton S. Hershey Medical Center
Department of Radiology and Radiological Sciences Hershey, Pennsylvania
Vanderbilt University The Imaging of Contraception
Nashville,Tennessee
Approach to Pelvic Pain and the Role of Imaging Akira Kawashima, MD, PhD
Professor
Tara Henrichsen, MD Department of Radiology
Instructor Mayo Clinic College of Medicine
Department of Diagnostic Radiology Consultant
Mayo Clinic Department of Radiology
Rochester, Minnesota Mayo Clinic
Approach to Imaging the Adnexal Mass Rochester, Minnesota
Pelvic Pain: Lower Urinary Tract—Urethral
Mindy M. Horrow, MD, FACR, FSRU, FAIUM Diverticulum, Cysts, and Varix
Associate Professor of Radiology
Department of Radiology Cheryl L. Kirby, BA, MD
Thomas Jefferson University School of Medicine Assistant Professor
Director of Body Imaging Department of Radiology
Department of Radiology Albert Einstein Medical Center
Albert Einstein Medical Center Philadelphia, Pennsylvania
Philadelphia, Pennsylvania Pitfalls in Gynecologic Ultrasound
Pitfalls in Gynecologic Ultrasound
Jill E. Langer, MD
Keyanoosh Hosseinzadeh, MD Associate Professor
Assistant Professor Department of Radiology
Department of Diagnostic Imaging University of Pennsylvania School of Medicine
University of Pittsburgh Medical Center Hospital of the University of Pennsylvania
Section Chief Philadelphia, Pennsylvania
Body Magnetic Resonance Imaging Benign Ovarian Masses
Department of Diagnostic Imaging
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
Müllerian Uterine Anomalies
viii Contributors

Yan Mee Law, MBBS, FRCR Sean E. McSweeney, FFRCSI, MB, BCh, BAO
Department of Diagnostic Radiology Joint Department of Medical Imaging
Singapore General Hospital University of Toronto
Singapore Toronto, Ontario, Canada
Imaging of Pelvic Floor Dysfunction Malignant Ovarian Masses
Cervical Cancer
Rashmi T. Nair
Ellie R. Lee, MD Cleveland Clinic Foundation
Assistant Professor Cleveland, Ohio
Department of Radiology Use of Positron Emission Tomography Imaging
Univeristy of North Carolina at Chapel Hill in€Gynecologic Cancers
Chapel Hill, North Carolina
Tubal Abnormalities Paul Nikolaidis, MD
Associate Professor of Radiology
Susanna I. Lee, MD, PhD Feinberg School of Medicine
Assistant Professor Northwestern University
Department of Radiology Chicago, Illinois
Harvard Medical School Uterine Artery Embolization
Chief of Women’s Imaging
Department of Radiology Ifeyinwa Y. Onyiuke, MB, BS
Massachusetts General Hospital Clinical Professor
Boston, Massachusetts Yale University School of Medicine
Drainage and Biopsy Procedures Attending Radiologist
Veterans Administration Connecticut Health Care System
Thomas Lemond, BA, MD New Haven, Connecticut
Radiology Resident Endometriosis
Postgraduate Year 2
University of Tennessee Health Sciences Center Tulin Ozcan, MD
Memphis,Tennessee Associate Professor
Gynecologic Imaging of the Pediatric Patient Department of Obstetrics and Gynecology
University of Rochester
Andrew J. LeRoy, MD Rochester, New York
Consultant The Normal Pelvis on Ultrasound Imaging
Department of Radiology and Anatomic Correlations
Mayo Clinic
Professor of Radiology Raj Mohan Paspulati, MD
Mayo Clinic College of Medicine Assistant Professor
Rochester, Minnesota Department of Radiology
Pelvic Pain: Lower Urinary Tract—Urethral Case Western Reserve University
Diverticulum, Cysts, and Varix University Hospitals
Cleveland, Ohio
Alfred Llave, MD Carcinoma of the Vagina and Vulva
Abdominal Imaging Fellow
Radiology Philip E. Patton, MD
University of North Carolina Professor
Chapel Hill, North Carolina Department of Obstetrics and Gynecology
Magnetic Resonance Imaging of the Female Pelvis: Oregon Health and Science University
Technique, Anatomy, and Pitfalls Portland, Oregon
Infertility, Evaluation, and Treatment
Shirley M. McCarthy, MD, PhD
Professor Hope E. Peters, MD
Department of Diagnostic Radiology and Obstetrics Instructor of Radiology
and Gynecology Department of Ultrasound
Yale University Brigham and Women’s Hospital
New Haven, Connecticut Boston, Massachusetts
Endometriosis Ultrasound-Guided Treatment of Ectopic Pregnancy
Adenomyosis
 Contributors ix

Misty Blanchette Porter, MD Clare M. Tempany, MD

Associate Professor Professor
Departments of Obstetrics and Gynecology Department of Radiology
and Radiology Harvard Medical School
Division of Reproductive Medicine and Infertility Department of Radiology
Dartmouth Medical School Brigham and Women’s Hospital
Hanover, New Hampshire Boston, Massachusetts
Medical Director Magnetic Resonance–Guided Ultrasound Surgery
In Vitro Fertilization and Assisted Reproduction of€Uterine Leiomyomas
Technology
Departments of Obstetrics and Gynecology Ashraf Thabet, MD
and Radiology Instructor in Radiology
Division of Reproductive Medicine and Infertility Department of Radiology
Dartmouth-Hitchcock Medical Center Harvard Medical School
Lebanon, New Hampshire Assistant Radiologist
The Ovary and Polycystic Ovary Syndrome Department of Radiology
Massachusetts General Hospital
Dmitry Rakita, MD Boston, Massachusetts
Chief Drainage and Biopsy Procedures
Body Magnetic Resonance Imaging
Department of Radiology Amy S. Thurmond, MD
Baystate Medical Center Director
Springfield, Massachusetts Medical Women’s Imaging Department
Assistant Professor Siker Medical Imaging and Intervention of Portland
Tufts University School of Medicine Portland, Oregon
Boston, Massachusetts Vaginal Fistulas
Adenomyosis Imaging of Pelvic Floor Dysfunction
Fallopian Tube Catheterization
Leslie M. Scoutt, MD
Professor of Diagnostic Radiology and Surgery Fauzia Q. Vandermeer, MD
Department of Diagnostic Radiology Assistant Professor
Yale University School of Medicine Department of Diagnostic Radiology
Chief University of Maryland School of Medicine
Ultrasound Service Baltimore, Maryland
Medical Director of the Non-Invasive Vascular Laboratory Ultrasound of the Normal and Failed
Department of Diagnostic Radiology First-Trimester Pregnancy
Yale-New Haven Hospital
New Haven, Connecticut Geoffrey E. Wile, BS, MD
Endometriosis Assistant Professor
Ectopic Pregnancy Department of Radiology
Vanderbilt University Medical Center
Shetal N. Shah, MD Nashville,Tennessee
Assistant Professor Approach to Pelvic Pain and the Role of Imaging
Department of Abdominal Imaging and Nuclear Medicine
Co-Director Jade Wong-You-Cheong, MBChB, FRCR
Center for Positron Emission Technology Professor
and Molecular Imaging Department of Diagnostic Radiology
Imaging Institute University of Maryland School of Medicine
Cleveland Clinic Baltimore, Maryland
Cleveland, Ohio Ultrasound of the Normal and Failed
Use of Positron Emission Tomography Imaging First-Trimester Pregnancy
in€Gynecologic Cancers
This page intentionally left blank

â•…â•…â•…â•…â•…
Preface

When Elsevier approached me with the idea of a textbook in the diagnosis of cancer, including positron emission
of gynecologic imaging I was ecstatic that a publisher tomography (PET) and MR diffusion imaging both during
was interested in promoting women’s health care and a and after therapy. Current American College of Radiology
little worried that there just was not a need for another Appropriateness Criteria are presented in an appendix.
textbook. Then I started looking carefully at the read- As radiology has expanded to become the primary
ing rooms where the on-call radiologists work. Virtually diagnostic and staging test for many gynecologic diseases,
every night two textbooks were open, one devoted to so has its role in therapy. Uterine artery emobilization
ultrasound and the other to computed tomography (CT), and focused ultrasound of fibroids, abscess drainage, and
both with images depicting gynecologic pathology. Imag- fallopian tube canalization are presented, with expert
ing of the female pelvis remains challenging because of advice on patient preparation, technique, and communi-
the anatomic complexity; the varied appearance of gyne- cation with referring physicians.
cologic diseases on CT, ultrasound (US) and magnetic Ultrasound is particularly challenging because of the
resonance imaging (MRI); and, often, the urgency of the transfer of real-time observations to images. With physi-
clinical situation. I contacted my co-editors, Drs. Brown cians performing less hands-on scanning, we risk losing
and Thurmond, and we began to plan. our ability to confidently identify common diseases and
Organization of Gynecologic Imaging is based on the especially the complications of early pregnancy. Several
questions and comments we have received during our chapters in this book are devoted to pelvic ultrasound,
course lectures, board review sessions, literature assess- with numerous high-quality images, including both gray-
ment, and interactions with both practicing radiolo- scale and color Doppler.
gists and trainees. Our textbook is divided into sections Finally, we have included a chapter specifically devoted
reviewing CT, US, and MRI techniques; normal anatomy; to radiation safety. We all want to decrease dose to our
and disease states. Particular attention is devoted to patients, but not at the expense of a diagnostic test. The
basic protocols that will provide the most critical clinical authors of this chapter discuss specific steps to decrease
information. This includes Doppler imaging, CT contrast dose and provide clinical scenarios and algorithms.
administration, and MR pulse sequences. Some types This book was written primarily for radiologists,
of benign disease of the pelvis have distinctive imaging gynecologists, and nurse practitioners who take care of
features and thus are presented separately from malig- women with pelvic disease. It provides a practical review
nant disease. Topics include infection, infertility, uter- of anatomy, appropriate imaging of benign and malignant
ine masses, and pelvic floor dysfunction. We have also disease of the female pelvis, and guidelines for patient
included images of disease states beyond the gynecologic management. In editing this book, we learned a great deal
tract that may mimic expected clinical findings. Cancers about our specialty. It is our hope that our readers will as
involving the uterus, cervix, ovaries, fallopian tubes, well.
and vulva are explored, with clear depictions of disease,
including line drawings and color prints of clinical find- Julia R. Fielding
ings. We have included the most current TMN staging sys- Douglas L. Brown
tem for each cancer adjacent to corresponding images. Amy S. Thurmond
Chapters are also devoted to new and evolving techniques

xi
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â•…â•…â•…â•…â•…
To my parents, husband, and son who tolerated long days, late nights, and travels away from home with
good humor; I owe my career to them.
To my mentors and colleagues, especially at Boston University Medical Center, Bringham and Women’s
Hospital, and the University of North Carolina at Chapel Hill; they continue to motivate me to strive for
excellence
To my many residents and fellows who inspire me with their confidence and abilities; they give me great
hope for the future of radiology and health care in America
To my co-editors, Dr. Amy Thurmond and Dr. Douglas Brown; all my thanks for your diligent work and
patience

Julia R. Fielding

To Tina, for her continuing love and support, which I treasure

To the rest of my family, for their caring
To the many others who have also been a part of my journey, especially those at the University of
Â�Tennessee in Memphis, Brigham and Women’s Hospital in Boston, and Mayo Clinic in Rochester – my
mentors and colleagues who guided me; the sonographers, students, nurses, and support staff who
helped me; the residents and fellows who �motivated me; and the patients and their families who are the
reason for what we do

Douglas L. Brown

To my ancestors from whom I inherited curiosity, drive, and the desire to make things better
To my immediate family, husband, and four children, who put up with the related qualities: stubbornness
and a chaotic schedule. They’ve helped me so much.

Amy S. Thurmond
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â•…â•…â•…â•…â•…
Contents

SECTION ONE:╇ IMAGING TECHNIQUES, PITFALLS, CHAPTER 10╇ Acute Pelvic Pain╅╇ 161
AND NORMAL ANATOMY Manjiri Dighe
Part 1:╇ Ultrasound CHAPTER 11╇ Chronic Pelvic Pain╅╇ 176
CHAPTER 1╇ The Normal Pelvis on Ultrasound Imaging Theodore Dubinsky, Manjiri Dighe, and Carlos Cuevas
and Anatomic Correlations╅╇ 5
Tulin Ozcan and Vikram Dogra CHAPTER 12╇ Pelvic Pain: Lower Urinary Tract—Urethral
Diverticulum, Cysts, and Varix╅╇ 192
CHAPTER 2╇ Pitfalls in Gynecologic Ultrasound╅╇ 21 Akira Kawashima, Douglas L. Brown,
Cheryl L. Kirby and Mindy M. Horrow and Andrew J. LeRoy

Part 2:╇ Computed Tomography

SECTION THREE:╇ ABNORMAL BLEEDING
CHAPTER 3╇ Computed Tomography: Normal Anatomy, Imaging
Techniques, and Pitfalls╅╇ 39 CHAPTER 13╇ Benign Endometrial Causes of Abnormal
Lejla Aganovic Bleeding╅╇ 209
Deborah A. Baumgarten
CHAPTER 4╇ Dose Reduction Techniques in Multidetector
Computed Tomography Body Imaging╅╇ 61 CHAPTER 14╇ Adenomyosis╅╇ 224
Lynne M. Hurwitz and Tracy A. Jaffe Dmitry Rakita and Shirley M. McCarthy

Part 3:╇ Magnetic Resonance Imaging CHAPTER 15╇ Uterine Leiomyomas╅╇ 237
CHAPTER 5╇ Magnetic Resonance Imaging of the Female Pelvis: Douglas L. Brown
Technique, Anatomy, and Pitfalls╅╇ 71
Julia R. Fielding and Alfred Llave
SECTION FOUR:╇ INFERTILITY
CHAPTER 6╇ Diffusion Magnetic Resonance Imaging╅╇ 103
CHAPTER 16╇ Infertility, Evaluation, and Treatment╅╇ 253
Jurgen J. Fütterer
Paula Amato and Philip E.Patton
Part 4:╇ Fluoroscopy
CHAPTER 17╇ Tubal Abnormalities╅╇ 266
CHAPTER 7╇ Hysterosalpingography: Techniques, Normal Ellie R. Lee
Anatomy, and Pitfalls╅╇ 113
Lauren M. Brubaker and Richard L. Clark CHAPTER 18╇ Müllerian Uterine Anomalies╅╇ 274
Golbahar Houshmand and Keyanoosh Hosseinzadeh

SECTION TWO:╇ PELVIC PAIN CHAPTER 19╇ The Ovary and Polycystic Ovary Syndrome╅╇ 289
Misty Blanchette Porter
CHAPTER 8╇ Approach to Pelvic Pain and the Role
of Imaging╅╇ 127 CHAPTER 20╇ The Imaging of Contraception╅╇ 301
Rochelle F. Andreotti, Geoffrey E.Wile, and Sara M. Harvey Keith C. Kaplan and David S. Hartman

CHAPTER 9╇ Endometriosis╅╇ 147

Ifeyinwa Y. Onyiuke, Leslie M. Scoutt,
and Shirley M. McCarthy
xv
xvi Contents

SECTION FIVE:╇ FIRST-TRIMESTER PREGNANCY CHAPTER 32╇ Uterine Cancers╅╇ 484

COMPLICATIONS Maureen S. Filipek
CHAPTER 21╇ Ultrasound of the Normal and Failed CHAPTER 33╇ Cervical Cancer╅╇ 499
First-Trimester Pregnancy╅╇ 317 Yan Mee Law
Fauzia Q.Vandermeer and Jade Wong-You-Cheong
CHAPTER 34╇ Ovarian and Fallopian Tube Cancer╅╇ 514
CHAPTER 22╇ Ectopic Pregnancy╅╇ 330 Steven C. Eberhardt and Margaret L. Gallegos
Lara Lyn Bryan-Rest and Leslie M. Scoutt
CHAPTER 35╇ Carcinoma of the Vagina and Vulva╅╇ 530
CHAPTER 23╇ Retained Products of Conception╅╇ 356 Raj Mohan Paspulati
Sara Durfee

CHAPTER 24╇ Gestational Trophoblastic Neoplasia╅╇ 367 SECTION NINE:╇ PEDIATRIC IMAGING
Maureen S. Filipek
CHAPTER 36╇ Gynecologic Imaging of the Pediatric
Patient╅╇ 547
SECTION SIX:╇ POSTPARTUM COMPLICATIONS Harris L. Cohen and Thomas Lemond
CHAPTER 25╇ Postpartum Complications╅╇ 381
Roberta diFlorio-Alexander and Robert D. Harris SECTION TEN:╇ INTERVENTIONAL RADIOLOGY
IN GYNECOLOGY
CHAPTER 26╇ Vaginal Fistulas╅╇ 399
Amy S. Thurmond CHAPTER 37╇ Drainage and Biopsy Procedures╅╇ 567
Ashraf Thabet and Susanna I. Lee
CHAPTER 27╇ Imaging of Pelvic Floor Dysfunction╅╇ 411
Julia R. Fielding, Amy S. Thurmond, and Yan Mee Law CHAPTER 38╇ Magnetic Resonance–Guided Ultrasound Surgery
of Uterine Leiomyomas╅╇ 583
Fiona M. Fennessy and Clare M. Tempany
SECTION SEVEN:╇ CHARACTERIZATION OF THE ADNEXAL
MASS CHAPTER 39╇ Uterine Artery Embolization╅╇ 600
Nancy Hammond and Paul Nikolaidis
CHAPTER 28╇ Approach to Imaging the Adnexal Mass╅╇ 427
Tara Henrichsen and Douglas L. Brown CHAPTER 40╇ Fallopian Tube Catheterization╅╇ 614
Amy S. Thurmond
CHAPTER 29╇ Benign Ovarian Masses╅╇ 437
Jill E. Langer CHAPTER 41╇ Ultrasound-Guided Treatment of Ectopic
Pregnancy╅╇ 627
CHAPTER 30╇ Malignant Ovarian Masses╅╇ 453 Hope E. Peters and Peter M. Doubilet
Sean E. McSweeney and Mostafa Atri

APPENDIX╅╇
SECTION EIGHT:╇ GYNECOLOGIC CANCER
Selections from the ACR Appropriateness
CHAPTER 31╇ Use of Positron Emission Tomography Imaging Criteria╅╇ 635
in€Gynecologic Cancers╅╇ 473
Shetal N. Shah and Rashmi T. Nair Index╅╇ 641
 SECTION

ONE

Imaging
Techniques,
Pitfalls,
and Normal
Anatomy
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