Modality	Imaging Type	Description / Use
US	Pelvic Ultrasound (Transabdominal and Transvaginal)	First-line imaging for uterus, ovaries, adnexa; evaluation of pelvic pain, masses, bleeding, infertility
US	Sonohysterography (Saline Infusion Sonography)	Ultrasound combined with saline infusion to evaluate endometrial cavity for polyps, submucosal fibroids, adhesions
CT	CT Abdomen and Pelvis With Contrast	Limited use in primary gynecologic imaging; used for staging malignancy, evaluating pelvic infections or trauma
MRI	MRI Pelvis	Gold standard for complex pelvic pathology: uterine anomalies, fibroids, adenomyosis, malignancy, endometriosis, congenital abnormalities
X-ray (Fluoroscopy)	Hysterosalpingography (HSG)	Evaluation of fallopian tube patency and uterine contour in infertility workup
NM	None (Routine NM studies are not typically first-line for female genital tract)
Endoscopy	Hysteroscopy	Direct visualization of endometrial cavity; evaluates polyps, fibroids, adhesions
Endoscopy	Laparoscopy	Direct visualization of pelvic organs; diagnostic and therapeutic (endometriosis, pelvic masses, infertility, ectopic pregnancy)

Clinical Pearls — Female Genital Tract Imaging

Clinical Scenario	Best Imaging First-Line
Evaluation of Abnormal Uterine Bleeding	Pelvic Ultrasound (Transvaginal if possible)
Infertility Workup	Pelvic Ultrasound + Hysterosalpingography (HSG)
Suspected Uterine Fibroids	Pelvic Ultrasound first; MRI Pelvis if complex or surgical planning needed
Suspected Endometrial Polyps	Sonohysterography or Hysteroscopy
Evaluation of Congenital Uterine Anomalies	MRI Pelvis (best anatomic delineation)
Evaluation of Pelvic Pain	Pelvic Ultrasound first; MRI Pelvis if inconclusive
Suspected Endometriosis	MRI Pelvis for deep infiltrating endometriosis
Pelvic Mass Characterization (complex ovarian or adnexal mass)	Pelvic Ultrasound first; MRI Pelvis for detailed evaluation
Staging Gynecologic Malignancies	MRI Pelvis (uterine, cervical, ovarian cancers)

The Common Vein