Interactive Transcript
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Okay, so now we've seen a
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nice case of kissing ovaries.
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So the other two patterns in superficial
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peritoneal disease include filmy
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adhesions and candle wax phenomenon.
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So I'll just talk a little bit about those.
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So filmy adhesions are the presence of
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web-like structures or wispy structures
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floating around in free fluid.
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And they really just are adhesions
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that have developed as a reaction
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to peritoneal endometriosis.
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And because they're quite thin,
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in this example, you can see this
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adhesion here and maybe a little bit of
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an adhesion here, they're quite thin.
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So they're challenging to see on MRI.
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So this is typically a finding that
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is noted on ultrasound, particularly.
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If you're scanning the patient, it
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probably wouldn't necessarily get captured
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on still images, but if you're scanning
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the patient, you can certainly look for
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these adhesions, and that's a good sign
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of superficial peritoneal endometriosis.
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And then the other feature in pattern two is the
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presence of what's called candle wax phenomenon.
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So it's a really nice description of what's
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going on, and that is the presence of
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multiloculated cystic structures that surround
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an endometrioma due to repeated hemorrhage.
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So as the bleeding happens over
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time within the endometrioma.
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We have some repeated areas of bleeding, and
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then healing, bleeding, and then healing,
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and that tends to accumulate around the ovary
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itself, and that's what these areas are.
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So this is a sign that we can sometimes see on
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MRI, and if you look for that, and if you're
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aware of it, you probably will find it, but
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it's also quite often seen on sonography.
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So once you have an endometrioma,
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we don't just stop there.
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We want to look outside the ovary.
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We want to look for the
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wispy or filmy adhesions.
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And then we want to look at
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the position of the ovaries.
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Are they midline or are they in
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their normal lateral position?
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So those are the typical
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manifestations of pattern two.
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