Interactive Transcript
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Okay, so here we have a case of an
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enormous cystic mass in this woman.
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She's perimenopausal.
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You can see that the uterus has been displaced
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anteriorly, and it's kind of compressed.
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The bladder is this thin black line here.
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So this is another case.
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Okay.
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The reason that we ask our patients to
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empty their bladder prior to the scan,
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if we know that we're imaging a mass, it
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makes it more, well, more comfortable or as
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comfortable as it can be for these patients.
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If they have a full bladder, then it makes it
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really difficult to stay still for the scan.
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So this enormous mass is what
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we're evaluating in this study.
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So you can see on the
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T2-weighted images here,
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it's fairly homogeneous, so it doesn't
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really have any septations within it.
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It's composed of primarily just
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simple high T2 signal fluid.
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And then on the post-contrast T1
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weighted images here, you can see
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that the fluid again is simple.
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There's no proteinaceous component
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and no hemorrhagic component.
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But what's interesting is we've got these
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very irregular-looking two focal areas.
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They almost look like, you know, flowers
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or what a bladder calculus would look
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like, but they're kind of multiflocculated
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stellate structures that are low T2 signal.
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They do enhance.
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So this is what that black sponge
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appearance looks like, where you've got
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the below T2 signal and entrapped or
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punctate areas of high T2 signal within it.
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And that's pretty typical
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of a cystadenofibroma.
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And what can be a little bit confusing
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and alarming is that these lesions, uh,
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the solid component rather enhances.
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So even though these are benign,
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they do have some features which
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are concerning for malignancy.
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And regardless of whether this is benign
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or malignant, this needs to come out.
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So just first of all, just based on
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the size, and then secondly, because of
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these peripheral enhancing components.
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So this is a really nice example of a
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cystadenofibroma with the black sponge.
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