Imaging of the female pelvis in the evaluation of developmental anomalies

Christopher Schelvan; Margaret A. Hall-Craggs; Rose de Bruyn

doi:10.1017/CBO9780511527036.011

10 - Imaging of the female pelvis in the evaluation of developmental anomalies

from Part II - Management of developmental abnormalities of the genital tract

Published online by Cambridge University Press: 04 May 2010

Christopher Schelvan ,

Margaret A. Hall-Craggs and

Edited by

Jane MacDougall and

Christopher Schelvan: Affiliation:
UCH Hospital Trusts, London
Margaret A. Hall-Craggs: Affiliation:
UCH Hospital Trusts, London
Rose de Bruyn: Affiliation:
Great Ormond Street Hospital for Children, London
Adam H. Balen: Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton: Affiliation:
University College London Hospitals
Melanie C. Davies: Affiliation:
University College London
Jane MacDougall: Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope: Affiliation:
Great Ormond Street Hospital

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Summary

Introduction

The use of imaging for the evaluation of developmental anomalies of the female pelvis has rapidly expanded since the 1980s mainly because of the development and availability of imaging technology, particularly high-resolution ultrasound with Doppler, spiral computed tomography (CT) and magnetic resonance imaging (MRI). Imaging is now used in virtually every case to confirm diagnosis or to show the anatomy of the structural abnormalities of the genital tract and other related disorders. Imaging is used extensively for planning the surgical management of the primary condition and any associated complications.

The most commonly used imaging modalities are fluoroscopy (usually with contrast agents), ultrasound and MRI. Each technique has particular advantages and disadvantages, and knowledge of these is important for the appropriate choice of imaging technique. A major consideration when imaging children is the use and dose of ionizing radiation, particularly as many patients are likely to need multiple investigations during the course of their lifetime.

Imaging modalities

Fluoroscopy

Genitograms and micturating cystourethrography are the traditional fluoroscopic methods for evaluating children with disorders of sexual differentiation. All perineal orifices are examined with the catheter inserted only a short distance into the orifice. Contrast is injected gently under direct fluoroscopic screening to allow visualization of the morphology of the urogenital sinus. The important features that are noted include the presence or absence of a vagina, its relationship to the urethra and the level of the external sphincter (which has important surgical implications), and the recognition of a male or female type urethral configuration (Aaronson, 1992).

Type: Chapter
Information: Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
, pp. 104 - 119

DOI: https://doi.org/10.1017/CBO9780511527036.011 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

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References

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10 - Imaging of the female pelvis in the evaluation of developmental anomalies

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