Interactive Transcript
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So we're going to switch gears a little bit
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and we're going to move to
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4 00:00:04,140 --> 00:00:04,290
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MRI imaging of adenomyosis.
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So this is a patient who was
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50 years old and had rectal cancer.
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So she got a rectal cancer MRI
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10 00:00:12,370 --> 00:00:12,549
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for incidental or for staging purposes.
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And again, we're radiologists,
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you have to look at everything.
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So we look at the uterus as well.
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So in her case, she has a very
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T2 dark fibroid, very well defined,
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but we're not gonna talk about that now
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'cause we're talking about adenomyosis.
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So what we're looking for here is,
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this is a good example of a
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thickened T2 dark junctional zone.
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It's a little bit asymmetric.
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So here's your T2 bright
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endometrium. That line in the middle
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is the anterior and posterior endometrium
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where they oppose each other and meet.
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This T2 dark junctional zone is thick,
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however, it's about 19 millimeters.
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In general, it should be
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less than eight millimeters.
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If it were between 8 to 12 millimeters,
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it's sort of a gray zone, but if you're
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more than 12 millimeters, it's too
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thick, you definitely have adenomyosis.
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You can see it's asymmetric posteriorly,
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where it's not nearly quite as thick.
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So this is just the muscular hypertrophy,
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we don't see any of this T2 bright foci.
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This is just thickening of adenomyosis.
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41 00:01:10,255 --> 00:01:12,345 It is important to think about other things
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that could mimic this, you know, are you
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in a slightly off plane of view because
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this was done for rectal cancer staging,
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the uterus might not be perfectly in plane.
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You can have mimics such
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as a uterine contraction.
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So if you have multiple phases, you can see
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if that relaxes at some point over time.
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And occasionally later in a menstrual
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cycle, you could potentially have
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a little bit of thickening there.
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So again, no T2 bright foci in this case.
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It's just the hypertrophied junctional zone here.
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In her particular case, too, she
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does have a C-section scar, just
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some other incidental findings here.
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On this particular image, too, it looks
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like it may even have an adhesion to
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the bladder right here, potentially,
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but hard to tell because, again, this
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was performed for rectal cancer staging,
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not specifically to evaluate the uterus.
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And then a few T2 bright Nabothian cysts
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in the cervix, which, again, pretty common.
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