Interactive Transcript
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Okay, and case four that we have here is a
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kind of bring it all together case where it
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has lots of different findings in adenomyosis.
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So this is one of those entities where
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you can have, you know, one of the
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findings, you can have two of the findings,
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or you can have all of the findings.
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So this is one where it has a
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lot of different findings here.
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So we're going to just start
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with some still images here.
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The uterus itself, a little bit globular here,
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with a fundus.
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And already endometrium, really hard to say what
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it is, is just this very thin stripe right here.
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Is it this whole larger structure right here?
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And then you see these echogenic nodules already
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emanating and a poor interface right there.
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So already we're thinking
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this person has adenomyosis.
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Keep scanning through a bit.
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Again, now you have a
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myometrial cyst right here.
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It almost looks like endometrium
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is really extending out here.
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It's really hard to tell exactly where the
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endometrium ends again, where it should
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be versus where it is in the myometrium.
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Now we have some color Doppler flow.
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We have, again, this penetrating
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appearance of the vessels as opposed to
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a fibroid right here and more echogenic
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emanating striations heading out.
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We have our nodules here again as well.
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So we have a little bit of everything
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on this particular patient.
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We go through our cine clips
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just again to show you those
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striations of echogenic nodules.
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little cysts, the poor interface.
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She's got all of the findings pretty much of
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adenomyosis minus the Venetian blind sign.
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That's pretty much the only one we
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don't have in her particular case.
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One more image here of the endometrial
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stripe in a slightly different view.
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She actually ended up having a little bit
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of everything, not just adenomyosis, but she
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did have a well-defined fibroid right here.
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And again, the difference here between this
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case and some of the other cases, you can see
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exactly where that fibroid stops and where
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the regular myometrium begins right here.
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So it probably has a
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submucosal component as well.
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It has a very different appearance than
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the adenomyosis that we've seen otherwise.
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Other things you might notice as you're
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scrolling through this case on your
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own is that there's a focal echogenic
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structure within the endometrium.
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So she actually ended up having a polyp as well.
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So she really did have a little bit
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of everything in this particular case.
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So if we go back to the still images
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and look at the 3D, remembering this
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is a retroverted retroflexed uterus, so
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everything's going to be flipped upside down.
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You can see beautifully her
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endometrium right here, right?
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We see a little divot right here and right here.
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One of those is probably going to be
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from that fibroid we saw right there.
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And you can also look for those
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little emanations coming out.
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If you look really closely, again,
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I wouldn't use this to decide it.
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I think it's better seen on the grayscale,
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but you can see some little striations
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that are coming out in different locations.
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Again, that's the endometrium
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extending out into the myometrium.
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Here we zoom in a little bit more.
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I think you can see them a little bit better.
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There's kind of nodules right
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here and just kind of confirms it.
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Fibroid right here with a submucosal
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component, more striations
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and nodules over here as well.
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So you can see it on 3D
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if you're looking for it.
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