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This is an MRI of the abdomen and pelvis

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in a patient with a positive home pregnancy

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test and an abnormal pelvic ultrasound.

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We have axial T2-weighted images of the

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pelvis, which demonstrate a distended

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endometrial cavity and a well-circumscribed

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T2 hyperintense structure within the

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lateral aspect of the right uterine fundus.

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We can also see a T2 hyperintense line

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extending from this structure toward the

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periphery of the uterus near the expected

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region of the fallopian tube ostium.

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We can also see the ovaries

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lateral to the uterus.

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This is the right ovary with multiple

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T2 hyperintense follicles present.

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And the left ovary is seen here adjacent

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to the left external iliac vessels.

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Again with multiple T2 hyperintense follicles.

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Coronal T2-weighted images of the

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pelvis in this patient demonstrate

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similar findings to the axial.

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With a well-circumscribed

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T2 hyperintense structure.

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in the right superior lateral aspect

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of the uterus, extending out toward

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the ostium of the right fallopian tube.

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This patient went to surgery, which confirmed

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a diagnosis of interstitial ectopic pregnancy.

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It's important to note that interstitial

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ectopic pregnancy is a particularly high

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risk manifestation of ectopic pregnancy.

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The interstitium of the uterus, which

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is this location, is hypervascular

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relative to the remainder of the uterus,

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and becomes even more hypervascular

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in the context of an early pregnancy.

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If an interstitial ectopic pregnancy

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ruptures, these patients are at

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risk of catastrophic hemorrhage.

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Additionally, it should be noted that this is

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technically not a corneal ectopic pregnancy.

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The term corneal ectopic pregnancy,

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or corneal pregnancy, is reserved for

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a pregnancy that has implanted within

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one cornu of a bicornuate uterus.

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So this is an interstitial

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ectopic pregnancy on MRI.