Radiographic Procedures of the Reproductive System

Summary

This presentation provides an overview of various radiographic procedures performed on the reproductive system, focusing on those under fluoroscopy and with limited overhead views for patient safety. It covers both non-pregnant and pregnant exams, such as Hysterosalpingography, Pelvic pneumonography, and Vaginography for females, and Fetography, Pelvimetry, and Fetal cephalometry for pregnant patients. It also touches on male reproductive imaging like Vesiculography and epididymography. Emphasis is placed on radiation protection and the use of sonography for pregnant patients. The procedures help diagnose issues such as tumors, infertility, and abnormalities in the reproductive organs.

Takeaways

• 😀 Non-pregnant female exams include Hysterosalpingography (HSG), Pelvic pneumonography, and Vaginography.
• 😀 Pregnant female exams include Fetography, Pelvimetry, and Fetal cephalometry.
• 😀 Hysterosalpingography (HSG) is used to evaluate the size, shape, and position of the uterus, as well as patency of the uterine tubes in cases of infertility.
• 😀 For HSG, water-soluble radiopaque contrast is injected into the uterus, and the procedure is typically scheduled within 10 days after menstruation to reduce risks.
• 😀 Before HSG, the patient’s bladder should be emptied, and the vaginal and perineal regions should be cleaned.
• 😀 Vaginography is used to investigate congenital malformations and fistulas, with contrast media introduced via a rectal retention tube inserted into the vagina.
• 😀 Procedures for pregnant women are often performed using sonography to minimize radiation exposure.
• 😀 Fetography images the fetus in utero and should only be performed after the 18th week of gestation.
• 😀 Radiographic procedures for males include imaging of the seminal ducts and prostate gland, such as Vesiculography and Epididymography.
• 😀 Sonography is the preferred imaging modality for the prostate to minimize radiation exposure to the gonads.
• 😀 Vesiculography can be used to screen for cancer, inflammation, or other abnormalities of the seminal ducts and epididymis.

Q & A

What is the primary purpose of Hysterosalpingography (HSG)?

Hysterosalpingography (HSG) is performed to determine the size, shape, and position of the uterus and uterine tubes. It can also help detect lesions such as polyps, tumors, or fistulous tracts, and evaluate the patency of the uterine tubes in patients with infertility.

Why is Hysterosalpingography scheduled within 10 days after the onset of menstruation?

Hysterosalpingography is scheduled within 10 days after menstruation to minimize the risk of irradiating a fertilized ovum, as the endometrium is less congested at this time.

What is the purpose of pelvic pneumonography and why is it no longer widely used?

Pelvic pneumonography was used to investigate the female pelvic region but has been largely replaced by sonography and other imaging techniques due to better diagnostic capabilities and reduced patient risk.

What is Vaginography used for?

Vaginography is used to investigate congenital malformations and fistulas in the vaginal region, using contrast media such as barium sulfate or iodinated contrast introduced via a rectal retention tube.

Why are pregnant patients typically preferred for procedures to be performed under Sonography?

Pregnant patients are typically preferred to undergo procedures under sonography because it minimizes radiation exposure to both the mother and the fetus, making it a safer option compared to radiographic techniques.

What is Fetography, and when should it be avoided?

Fetography is imaging of the fetus in utero, typically performed after the 18th week of gestation. It should be avoided before this point to reduce risks to the developing fetus.

What is Pelvimetry used for in radiography?

Pelvimetry is used to assess the pelvic structure, comparing it with the size of the fetal head to evaluate the adequacy of the birth canal for delivery.

What does Fetal cephalometry measure?

Fetal cephalometry is used to measure the size and proportions of the fetal head in relation to the mother’s pelvis, helping to assess the feasibility of a vaginal delivery.

What is the role of Vesiculography in male reproductive imaging?

Vesiculography is used to investigate abnormalities in the seminal ducts, such as cysts, abscesses, tumors, inflammation, and sterility, by introducing contrast into the ductus deferens.

Why is sonography preferred over prostatography in modern imaging?

Sonography is preferred over prostatography because it provides a safer, non-invasive alternative with lower radiation exposure, making it ideal for prostate imaging, especially to protect the gonads.