Interactive Transcript
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This is an MRI of the abdomen and
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pelvis in a patient with a very
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early first-trimester pregnancy.
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These are axial T2-weighted images
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of the pelvis, and as we move toward
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the pelvic inlet, we begin to see
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the gravid uterus come into view.
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We can see this layer of T2
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heterogeneous myometrium surrounding
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the distended endometrial cavity, which
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contains a T2-bright gestational sac.
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This comma-shaped structure within
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the gestational sac is the embryo.
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We can see that the amniotic fluid volume
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is qualitatively normal for this patient.
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We also see the ovaries in this patient.
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Here's the left ovary.
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It's lateral and anterior to the uterus along
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the course of the anterior iliac vessel.
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Here's the right ovary.
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It's located posterior to the uterus in this
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patient, which is fine because the ovaries
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are mobile structures within the pelvis.
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This peripherally T2-dark structure within
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the right ovary is a corpus luteum, so we can
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estimate that this patient likely ovulated on
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the right side in the context of this pregnancy.
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These are coronal T2-weighted
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images of the abdomen and pelvis.
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Again, we can see the mildly enlarged gravid
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uterus with T2 heterogeneous myometrium and the
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gestational sac within the endometrial cavity.
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We can see very early limb buds within
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this tiny embryo in addition to a yolk sac.
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And again, this is the left ovary, which
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contains T2 hyperintense follicles.
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And this is the right ovary, which contains
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that peripherally T2-dark corpus luteum.
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Lastly, let's evaluate this early first
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trimester pregnancy on sagittal T2-weighted MR.
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Again, we see the gravid uterus with the
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gestational sac containing T2-bright fluid.
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This is our small early embryo.
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And what I'd like to point out on the sagittal
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images is the exquisite pictures that we
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can get of the cervix and cervical canal.
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Again, this is the anterior lip
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and posterior lip of the cervix.
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We see a very small amount of
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fluid within the cervical canal.
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That's normal.
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But the internal os is closed, which is
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important for us to document, particularly
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in the first trimester of pregnancy.
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