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First Trimester MR (7 weeks)

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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.

Report

Faculty

Erin Gomez, MD

Assistant Professor of Radiology

Johns Hopkins Hospital

Tags

Women's Health

Uterus

Ovaries

MRI

Gynecologic (Gyn)

Gynecologic (GYN)

Genitourinary (GU)

Cervix

Body

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