CT Scan | Uterus

Ashley Davidoff MD

Identifying Uterine Disease and and Local Complications

Enlarged Uterus Endometrial Carcinoma with Hydrosalpinx

This 70 year old female presents with pelvic discomfort. The CT shows an endometrium (orange in b) filled with complex soft tissue in the endometrial cavity (green in b) and the Fallopian tubes are distended with fluid (yellow in b and d) caused by the obstructing carcinoma. The uterus is enlarged

Ability to Characterize Small Bubbles of Air and Incriminate Anaerobic Infection

Obstruction and Infection

The axial CTscan is from a 46 year old female with cervical carcinoma. The images show an expanded irregular endometrial cavity (yellow) that contains air (black), thickened irregular cervix (soft tissue green), and fluid (yellow).

These findings are consistent cervical carcinoma or less likely endometrial with secondary obstruction and pyometria.

Obstructed Uterus with Pyometria

46 year old female with obstructed uterus and fluid filled endometrial cavity with pockets of air caused by cervical carcinoma complicated by pyometria.

Metastases

Metastasis to the Right Ureter Causing Hydronephrosis

The CTscan of a 58 year female with expanded endometrial cavity is shown. (a,b) The cavity is filled with heterogenous material (green) representing a combination of tumor, fluid necrotic material and blood. Pathology showed adenocarcinoma, endometriod type, grade I/III with tumor necrosis. Tumor involvement of the right ureter (arrow in c) and secondary hydronephrosis of the right kidney is present. (d)

Beyond the Pelvis

Peritoneal Metastases

79 year female with transperitoneal metastasis from endometrial carcinoma overlaid in green. Fatty liver is present.

CT Guided Biopsy

Regional Nodes

61 year old female with enlarged endometrial cavity and cervical mass consistent with cervical carcinoma complicared by obstruction of the endometrial cavity. The cavity is filled with complex material probably from a combination of secretions, fluid, blood and tumor. Lymph nodes in the left paraaortic area (c, white arrow) were biopsied under CT guidance (d) and were positive for cervical cancer.

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References

Kaura, H, Loyera E M, Minamib, M Charnsangaveja C Patterns of uterine enhancement with helical CT European Journal of Radiology Volume 28, Issue 3, Pages 250-255 (October 1998)