Endometritis

Preliminary Diagnosis: Endometritis

I. What imaging technique is first-line for this diagnosis

• Ultrasound of the pelvis; transvaginal imaging offers better evaluation compared to a transabdominal approach.

II. Describe the advantages and disadvantages of this technique for diagnosis of endometritis.

Advantages

• Highly portable imaging modality that does not expose patients to ionizing radiation

• Offers exquisite visualization of the surrounding vasculature

Disadvantages

• Limited in sensitivity and specificity in evaluating the surrounding soft tissues and osseous structures

• Limited in giving a detailed evaluation of the surrounding soft tissues

• Limited in characterizing any secondary complications

• Highly operator dependent

• Endometritis is more of a clinical diagnosis

III. What are the contraindications for the first-line imaging technique?

• No specific contraindications to sonographic imaging exist

IV. What alternative imaging techniques are available?

• MRI

• CT imaging of the pelvis with and without contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of endometritis.

MRI

Advantages

• Does not expose patients to ionizing radiation

• Offers great sensitivity and specificity in evaluating the soft tissues and layers of the uterus and is able to detect any secondary complications.

Disadvantages

• Expensive

• Time-consuming

• May be subject to motion and susceptibility weighted artifact

• Endometritis is more of a clinical diagnosis

CT Imaging of the pelvis with and without contrast

Advantages

• Offers exquisite detail of the surrounding soft tissues and osseous structures

• May help guide treatment, therapy, and biopsy

• Relatively quick imaging modality compared to MR imaging

Disadvantages

• Exposes patients to ionizing radiation

• Offers less detailed evaluation of the surrounding soft tissues and the soft tissues of the uterus

VI. What are the contraindications for the alternative imaging techniques?

MRI

• Contraindicated in patients with non-MR compatible hardware

CT Imaging of the pelvis with and without contrast

• May be contraindicated in patients who are pregnant

• Relative contraindication to intravenous contrast use in patients with renal failure or contrast allergy