MRI Case Study

Because this is a female, one possibility would be an ovarian cyst, though it does not have the typical appearance for this and is located slightly higher than would be expected, but this is a possibility. Other benign possibilities are a peritoneal cyst or mesenteric cyst. There can also be choledochal cysts but usually these are higher up near the liver. There can also be intestinal duplications cysts and other cysts related to the intestines. Unfortunately, it is not possible to make a confirmed diagnosis of which type of cyst until

The definitive diagnosis of endometriosis is made by histologic examination of a biopsied lesion collected during laparoscopy. However, the first line study for the diagnosis of endometriosis is pelvic ultrasound (US). The ultrasound can provide the FNP information that corroborates the suspicion of endometriosis, such as adnexal nodular mass, rectovaginal or bladder nodules (Solnik, 2015). Nonetheless, early stages of endometriosis may not be detected by transvaginal US. Rectal US may also be an appropriate test to visualize deep pelvic endometriosis or involvement of the colon or rectum (Solnik,

Patients with early, normal intrauterine pregnancies often present with signs and symptoms similar to those encountered in patients with ectopic pregnancies and other gynecologic or gastrointestinal conditions. The availability of various biochemical, ultrasonographic, and surgical modalities can aid in establishing a definitive diagnosis and differentiating among various conditions. Serum β-HCG levels correlate with the size and gestational age in normal embryonic growth. In a normal pregnancy, the β-HCG level doubles every 48–72 hours until it reaches 10,000–20,000 mIU/mL. In ectopic pregnancies, β-HCG levels usually increase less. Ultrasonography is arguably the most important tool for diagnosing an extrauterine pregnancy, although it is more frequently used to confirm an intrauterine pregnancy. Ultrasonography for a presumed ectopic pregnancy shows an empty uterus on endovaginal ultrasonographic images in patients with a serum beta–human chorionic gonadotropin (β-HCG) level greater than the discriminatory cutoff value is an ectopic pregnancy until proven otherwise. An empty uterus may also represent a recent abortion. In the presence of a definite ectopic pregnancy, a thick, brightly echogenic, ringlike structure is located outside the uterus, with a gestational sac containing an

Radiologic abnormalities on an ultrasound would show polycystic ovaries. Polycystic ovaries are the formation of clusters of pearl-sized cysts containing immature eggs in the ovaries. In healthy women, a follicle grows and at the time of ovulation, an egg is released into the Fallopian tube. In women with polycystic ovary syndrome, the development of the follicle is arrested and the egg does not burst forth. Therefore, the egg dies and the follicle becomes a cyst that remains in the ovary (Banning 635-636).

CT or MRI is recommended for cysts larger than 1 cm in order to be categorized for high risk stigmata.

However, variations exist on ultrasounds from intraductal lesions associated with ductal dilatation and a predominantly solid pattern with the intraductal or intracystic mass totally filling the

It is worth knowing that although the recommendations of the ACR is close follow up for BIRADS 3 lesions without taking biopsy, yet there is controversy in that issue, the other opinion is that biopsy should be considered. This demonstrates how it is highly valuable that a BIRADS 3 lesion could be reclassified as BIRADS 2, in order to decrease the number of biopsies (123)

Sonhysterography uses saline to fill the uterine cavity while using ultrasound to visualize any abnormalities. Hysterosalpingography uses a contrast filling technique under fluoroscopic guidance to visualize any filling defects that may occur in the fallopian tubes or uterine cavity which could be due to fibroids located in a the walls of the endometrium. The most common way to treat fibroids is with a uterine embolization technique. Although this type of treatment is very effective it can also expose the patient to high radiation doses. This is really dependent on the skill level of the physician, the beam on time, and any complications that may arise. Another efficient way to treat fibroids is with the magnetic resonance imaging-guided focused ultrasound ablation of fibroids. This form of treatments does not use any form of ionizing radiation there for no radiation is administered to the patient. However, the success of this procedure can be affected if the patient possesses anything that could block or deflect the beams path such as abdominal scars or surgical

Ascites: There is fullness of the flanks. On percussion, flanks are dull with resonance in the center. There may be presence of fluid thrill and positive shifting dullness. On auscultation, there is absence of any rub sound unlike in ovarian tumor. Sometimes, the ovarian tumor is as big as a mucinous cyst adenoma and it is difficult to differentiate by clinical examination alone. In such cases, abdominal paracentesis and examination of the fluid can give a clue in the diagnosis.

In the journal article, An Unusual Case of Asymptomatic Spontaneous Umbilical Endometriosis Treated with Skin – sparing Excision, the author discusses the study of an unusual case of umbilical endometriosis in a healthy thirty nine year old healthy female. “Medical research proves that endometriosis usually affects woman that have a difficult menstrual cycle accompanied with a great amount of pain” (WebMd). “Umbilical endometriosis is a rare buildup of endometriosis in the umbilical cord, due to the known history that the disease is typically a manifestation outside of the uterus as a result of tissue built up” (Arkoulis N).

□ Used when findings on hysterosalpingosonogram are concerning for intrauterine lesions that would need to be addressed.

Ultrasonography is an important type of diagnostic testing method that is used all around the world today in mostly hospitals and gynaecology clinics. The Wikimedia Foundation states, “It is used to see internal body structures such as tendons, muscles, joints, blood vessels, and internal organs” (“Medical” par. 1). Therefore, the use of ultrasounds can evaluate these specific parts of the body. X-rays can not evaluate the internal organs of the body. As BBC states, “Compared to x-ray photographs, ultrasound scans: Produce images of soft tissue” (“GCSE” par. 1). It is important that we have ultrasounds to evaluate the internal organs of the body. Ultrasounds also examine pregnant women for nine months. According to the Wikimedia Foundation, “The practice of examining

Our next patient was a younger woman who needed to come in for a pelvic ultrasound. She said she was having a lot of pain within her periods, and they were abnormally heavy. The pelvic ultrasound usually consists of first having an external ultrasound of the area looking at the reproductive organs, but than also having an internal ultrasound which would further allow clearer images. Within the external ultrasound, Rachel right away found that there was a spot in the lining of one of her ovaries, and this would be causing the pain and the heavy bleeding. She wanted to confirm this for the radiologist with an internal ultrasound, so she asked the woman if she wanted to go on with this or not, and the patient said yes so we further went on with the internal ultrasound. The images from this ultrasound just further agreed with the previous images taken, so Rachel then sent these to the radiologist and then he will deliver the news to the patient within the next couple hours. One important thing to remember when being a sonographer is that they cannot diagnose anything, so there is very little information a sonographer can give to a patient. Our next patient was a 40-year-old woman who needed a thyroid ultrasound. This scan was a pretty basic thyroid scan, but the woman had a lot of different nodules within the thyroid. This scan took a while to complete

1-Ultrasonography is the least expensive choice for screening, but it is highly operator-dependent. A suspicious lesion on a sonogram generally requires additional imaging studies to confirm the diagnosis and the stage of the tumor. Sensitivity of ultrasonography for detection of small nodules is low. An advantage is that Doppler imaging can be performed at the same time to determine the patency of the portal vein

The studies were conducted both on pregnant and nonpregnant women. The scar defects were evaluated based on shape, size, and thickness of residual myometrium. In an unscarred, the lower uterine segment (LUS) is viewed as three-layered structure. The inner layer includes chorioamniotic membrane and endometrial layer. Middle layer includes myometrium, and outer layer includes peritoneal reflection and bladder wall (Cheung 2004). As the pregnancy progress, the LUS develops and the layers changes in sonographic resolution. Myometrium becomes thinner gradually and less distinguished later on in the pregnancy. Whereas in as scarred uterus different layers are not well demarcated, the LUS is comparatively thin. It is considered as scar defect if there is a window or defect in the myometrium. The CS scar was measured in two planes, transverse and sagittal. In the sagittal plane, scar depth, width and residual myometrial thickness (RMT, between hypoechoic indentation at the bottom of the scar to the hyperechoic line of the uterovesical fold) measured and the length of the scar measured in the transverse plane (Naji 2012).