RD7.{1,6} | Imaging in Obstetrics, Gynecology and Breast Care — Glossary

An ovarian or adrenal tumour producing excess androgens; suspected when virilisation is rapid or severe with markedly raised testosterone, and investigated with pelvic ultrasound and cross-sectional imaging (MRI/CT) rather than treated as PCOS.

The ultrasound count of small 2-10 mm follicles across both ovaries in the early follicular phase; a marker of ovarian reserve, with a low count indicating diminished reserve.

The principal lymphatic drainage of the breast; their involvement is central to breast-cancer staging and is assessed by ultrasound (with image-guided sampling of suspicious nodes) to guide surgical and systemic treatment.

Breast Imaging Reporting and Data System — a standardised reporting scheme with assessment categories 0-6, each carrying a defined management recommendation, used to communicate breast imaging findings unambiguously.

Category 4 = suspicious (biopsy should be considered); category 5 = highly suggestive of malignancy (biopsy and appropriate action); both prompt image-guided core biopsy for tissue diagnosis.

Tumour-suppressor genes whose pathogenic mutations markedly raise breast (and ovarian) cancer risk; carriers are offered MRI-based high-risk screening, often alongside mammography, because of their elevated and earlier-onset risk.

The proportion of glandular/fibrous (radio-opaque) tissue in the breast; high density (common in younger women) reduces mammographic sensitivity because cancer and dense tissue both appear white, favouring ultrasound or MRI.

Gadolinium-enhanced magnetic resonance imaging of the breast; the most sensitive modality, used for high-risk screening (e.g. BRCA carriers), staging/extent of disease, equivocal cases and implant assessment; no ionising radiation but lower specificity.

Radiation-free imaging that characterises a breast lesion as solid or cystic and assesses its margins; the first-line imaging for a lump in young women (<~40), in dense breasts, and in pregnancy/lactation, and used to guide biopsy.

Transient contraction of the uterine cornu during HSG that prevents contrast entering the proximal tube and mimics a true proximal block — a recognised false positive that must be confirmed before management.

The serum beta-hCG level (~1500-2000 IU/L for transvaginal ultrasound) above which an intrauterine gestational sac should normally be visible if the pregnancy is intrauterine; an empty uterus above this level is suspicious for ectopic or non-viable pregnancy.

Two concentric echogenic rings around an eccentrically implanted early intrauterine gestational sac, a supportive feature of a true intrauterine pregnancy distinguishing it from a pseudosac.

A pregnancy implanted outside the uterine cavity, most commonly in the fallopian tube (ampulla); the leading cause of first-trimester maternal death, usually from haemorrhage after tubal rupture.

The ultrasound measurement of the endometrial lining; assessed in women with prolonged amenorrhoea and unopposed oestrogen because PCOS carries an increased risk of endometrial hyperplasia.

The count of 2-9 mm antral follicles in a single ovary on ultrasound; ≥20 (high-frequency probe) or ≥12 (older equipment) satisfies the morphological criterion for PCOM.

Serial transvaginal ultrasound during ovulation induction to count and measure developing follicles and time ovulation, intercourse or trigger; the active role of imaging in PCOS-related fertility management.

Blood within the peritoneal cavity, seen on ultrasound as echogenic free fluid; in suspected ectopic pregnancy it signals tubal leakage or rupture and, with haemodynamic instability, mandates emergency surgery.

A coexisting intrauterine and ectopic pregnancy; rare in spontaneous conception but markedly more common after assisted reproduction (IVF), so the adnexa must be examined even when an intrauterine pregnancy is seen.

A distally blocked, fluid-distended fallopian tube appearing as a sausage-shaped dilated structure; its fluid is toxic to implantation and lowers IVF success, so salpingectomy or occlusion is advised before IVF.

Clinical (hirsutism, acne, male-pattern hair loss) or biochemical (raised free testosterone / free androgen index) evidence of androgen excess; one of the three Rotterdam criteria for PCOS.

An ultrasound-based, radiation-free alternative to HSG that assesses tubal patency by watching the flow of an ultrasound contrast/saline-air medium along the tubes on transvaginal scanning.

A fluoroscopic test in which iodinated contrast is instilled through the cervix to outline the uterine cavity and fallopian tubes; free peritoneal spill confirms tubal patency. Performed in the follicular phase (days 6-10) after excluding pregnancy and active infection.

Sampling of a breast lesion under ultrasound, stereotactic mammographic or MRI guidance to obtain tissue for histological diagnosis; the pathology limb of the triple assessment for BI-RADS 4-5 lesions.

Failure to conceive after twelve months of regular unprotected intercourse (or six months if the woman is over 35 or there is a known risk factor); evaluated across ovarian, tubal and uterine factors plus the male factor.

An ectopic pregnancy implanted in the interstitial (cornual) portion of the tube within the uterine wall, with a thin surrounding myometrial mantle; prone to late, catastrophic rupture.

Bands of scar tissue within the uterine cavity, often following instrumentation, causing light periods and infertility; seen on SIS/hysteroscopy as bridging bands or a partly obliterated cavity and corrected hysteroscopically.

The definitive, gold-standard test of tubal patency in which methylene-blue dye is instilled and spill from the fimbrial ends is observed directly; also visualises endometriosis and adhesions.

Low-dose X-ray imaging of the compressed breast (standard craniocaudal and mediolateral-oblique views); the screening modality for breast cancer, especially good at detecting microcalcifications, with reduced sensitivity in dense breasts.

A folate-antagonist chemotherapeutic used to treat selected stable, unruptured ectopic pregnancies with low beta-hCG, no fetal cardiac activity and small mass, with response monitored by serial beta-hCG.

Tiny calcium deposits on mammography; clustered, pleomorphic or fine branching/linear microcalcifications are suspicious for malignancy (especially ductal carcinoma), whereas coarse or rim calcifications are usually benign.

A congenital uterine malformation (e.g. septate, bicornuate, unicornuate uterus) characterised by 3D ultrasound or MRI using the external fundal contour to distinguish septate from bicornuate, an important distinction for management.

A normal ovary containing several follicles of variable size distributed throughout, with normal volume — physiologically common in adolescents and the early follicular phase; it is NOT polycystic ovarian morphology.

Infrequent or absent ovulation, manifesting clinically as oligomenorrhoea or amenorrhoea; one of the three Rotterdam criteria for PCOS.

The quantity of remaining oocytes, reflected by the antral follicle count and serum anti-Mullerian hormone (AMH); diminished reserve adds urgency to fertility counselling and treatment.

Ovarian size calculated as 0.523 × length × width × height; a volume >10 mL in either ovary (without a dominant follicle, cyst or corpus luteum) satisfies the PCOM criterion and is the criterion of choice when follicles cannot be counted reliably.

The ultrasound appearance of a polycystic ovary: ≥20 follicles of 2-9 mm per ovary on a high-frequency transducer (or ≥12 on older equipment) and/or ovarian volume >10 mL in at least one ovary.

A common endocrine disorder of reproductive-age women characterised by oligo/anovulation, hyperandrogenism and/or polycystic ovarian morphology, with associated metabolic risk; diagnosed by the Rotterdam criteria.

The rectouterine pouch, the most dependent part of the female pelvis; free fluid here is assessed on ultrasound — echogenic fluid suggests haemoperitoneum from a leaking or ruptured ectopic.

A positive pregnancy test with neither an intrauterine nor an extrauterine pregnancy visible on transvaginal ultrasound; a temporary classification resolved by serial beta-hCG and repeat scanning, never discharged as 'normal'.

A central fluid collection within the endometrial cavity that can accompany an ectopic pregnancy and mimic an intrauterine sac; distinguished by its central position, absent double decidual sign and absent yolk sac.

The 2003 ESHRE/ASRM consensus criteria for PCOS: a diagnosis requires any TWO of three features — oligo/anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound — after excluding mimics.

Distension of the uterine cavity with sterile saline during transvaginal ultrasound to delineate endometrial polyps, submucous fibroids, intrauterine adhesions and a septum.

Surgical removal of the affected fallopian tube (salpingectomy) or incision and evacuation of the ectopic while conserving the tube (salpingotomy); the surgical options for ectopic pregnancy, usually performed laparoscopically.

The detection of disease in asymptomatic people before symptoms appear, aiming to reduce mortality; breast screening uses mammography in defined age ranges and balances benefit against harms such as false positives and overdiagnosis.

Beta subunit of human chorionic gonadotrophin secreted by trophoblast; in early pregnancy it reflects trophoblastic mass (not location) and is interpreted alongside ultrasound and against the discriminatory zone.

A mass with radiating linear margins on mammography or ultrasound, a feature highly suspicious for invasive malignancy because of the infiltrative growth of cancer into surrounding tissue.

Cross-sectional and nuclear imaging used to detect distant metastatic spread (lung, liver, bone) in higher-stage or symptomatic breast cancer; these stage disease and do not detect the breast primary, which is assessed by mammography, ultrasound and MRI.

The descriptive ultrasound appearance of a polycystic ovary in which numerous small uniform follicles are arranged peripherally around increased central stroma.

A uterine leiomyoma projecting into or indenting the endometrial cavity, seen as a cavity-distorting hypoechoic mass on TVS/SIS; may impair implantation and is treated hysteroscopically.

Ultrasound of the pelvis performed through the abdominal wall and a full bladder; used when transvaginal scanning is not feasible, with ovarian volume rather than follicle count as the reliable morphological criterion due to lower resolution.

Ultrasound performed with a high-frequency endovaginal probe placed close to the pelvic organs; the first-line modality for assessing ovarian morphology in sexually active women because of its superior spatial resolution.

The integrated evaluation of a breast lesion by clinical examination, imaging (mammography and/or ultrasound), and pathology (core biopsy or FNAC); concordance between the three gives a reliable diagnosis, and discordance is always investigated further.

Openness of the fallopian tubes allowing egg and sperm to meet; assessed by HSG, HyCoSy or laparoscopy with dye, with free peritoneal spill of contrast/dye indicating a patent tube.

An adnexal echogenic ring with a hypoechoic centre ('bagel'/'donut') lying separate from the ovary on ultrasound; a highly specific direct sign of a tubal ectopic pregnancy.