Normal CT abdomen and pelvis - female

Normal CT abdomen and pelvis - female

Normal CT abdomen and pelvis - female


Introduction

The primary indications for abdomen-pelvis computed tomography (CT) in females include trauma, acute pelvic pain (e.g., appendicitis, diverticulitis, ovarian torsion), gynecologic malignancies (e.g., staging of cancers, assessment of tumor recurrence), pelvic inflammatory disease, and postmenopausal pelvic pain (e.g., ovarian cysts, masses, uterine fibroids with torsion or necrosis).
CT is particularly valuable in emergency settings due to its rapid, noninvasive, and comprehensive evaluation capabilities, enabling detailed assessment of abdominal and pelvic structures. This includes the reproductive organs, especially in cases of nonspecific clinical presentations or when ultrasound (US) findings are inconclusive.
The objective of this study is to illustrate the normal anatomy of the female abdomen and pelvis as visualized on CT scans, thereby enhancing accuracy in interpretation. Additionally, an interactive map of liver segmentation and gastric lymph node stations has been developed as part of this module.
 

Materials and Methods

Abdomen and pelvis CT scan was performed on a healthy 43-year-old female patient, with iodinated contrast agents and using a Philips CT scanner.

  • Slice thickness: 1 mm
  • Slice spacing: 0.5 mm

Coronal and sagittal multiplanar reconstructions (MPR) and 3D volume-rendered images were generated from the same CT DICOM dataset. Antoine Micheau, MD (Radiologist, Montpellier, France) performed these reconstructions using a GE ADW workstation.
During the labeling process, the following observations and decisions were made:

  1. The right ovary presents a 40 mm follicular cyst (Simple follicles are typically smaller, usually less than 3 cm in diameter, while ovarian cysts can be larger. Follicular cysts, a type of functional cyst, can range from 0.5 cm to over 8 cm in size).
  2. A small hiatal hernia was identified.
  3. The appendix was not visible; for educational purposes, a small “false appendix” was added to the images.
  4. The pancreatic duct was not visible but was labeled along its most probable trajectory.
  5. Peritoneal recesses were labeled for reference, although they are not discernible in the absence of peritoneal effusion.
  6. The umbilical vein, which is occluded in adults, was labeled for didactic purposes alongside the ligamentum venosum in the same location.
  7. Mild nonspecific degenerative changes were noted in the symphysis pubis joint.

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