Interactive Transcript
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So our next case is a 20-year-old who's six
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months postpartum. Looking at our sagittal uterus
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picture, wWe can already see some heterogeneity.
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As we scroll through it, you almost wonder if
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there's a venetian blind effect, and that's where this
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alternating, like, bright and dark.
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Here, like a Venetian blind, could cause shadows.
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That's what a Venetian blind sign is.
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However, you have to note
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where they're coming from.
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If they are tracking back to the uterine
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arcuate arteries, which will be in the periphery
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right here, that's not a Venetian blind.
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That's just an artifact
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because of the vessels there.
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You know, you can have increased through
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transmission because of the endometrium
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itself, tThat's not necessarily it.
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So you have to be aware of where
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those Venetian blinds are coming from.
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And that's not just, you know, physiologic
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coming from the arcuate arteries.
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It would have to come from the
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myometrium itself to suggest adenomyosis.
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But, as we're going through here,
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we do have a submyometrial cyst
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right here below the endometrium.
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It is not in the endometrium itself.
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And so small cysts at the endometrium,
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myometrium junction, those are going to be the
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most sensitive and specific for adenomyosis.
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So if you see those, they should range
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from about 1-5 millimeters in size,
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which this one definitely would fit.
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I'd like to see more than one, but
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if you have other signs, you don't
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necessarily need to see more than one.
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In this particular case, it felt like
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you could probably see some little
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echogenic nodules right here as well.
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So the difference here is these
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are ectopic endometrial
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tissue, but so is this.
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But in this particular case, it probably bled
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at some point and now is just fluid-filled.
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So it's just a different appearance of
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these ectopic endometrial glands right here.
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So in this particular case, we have the cysts.
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We have some echogenic nodules.
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The uterus itself is a bit globular.
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It's really quite a large uterus right here.
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So this is a case that is probably adenomyosis.
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She's very young, but again,
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you can get adenomyosis in your 20s.
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So this is one where I would suggest
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it's adenomyosis because it certainly
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looks like it's heading that way,
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if it's not adenomyosis already at this point.
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