Interactive Transcript
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This pelvic ultrasound is of a 42-year-old who came
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in with an LMP of two days prior to her imaging.
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She came in for intermenstrual bleeding.
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As we scroll through this sagittal cine clip,
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we have a lot of different findings here.
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We have some venetian blind sign; again,
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ignoring the ones coming from the vessels. q 8 00:00:19,160 --> 00:00:22,250 We have some venetian blind sign over
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here that suggests some adenomyosis,
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and there are ill-defined borders
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of the endometrium and myometrium,
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particularly back here.
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So we definitely have some adenomyosis, but we
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have this structure in the endometrium, and we
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see a lot of shadowing here, not just a venetian
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blind — you know, dark, bright, dark, bright —
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but you know, lots of dark here, a little bit
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of bright, little bit of dark, more bright here.
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This is not a venetian blind.
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You also can see that there's some, you know,
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sort of echogenic areas that are coming from.
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So this might be a partially calcified
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mass that's in the endometrium right here.
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Look at our color Doppler imaging; see if
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that gives us a little bit more information.
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And here's your venetian blind
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type of appearance of adenomyosis.
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And if you see some penetrating
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vessels in the color Doppler flow,
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then as we get towards the endometrium,
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we see a bit more flow to this structure.
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Sort of disorganized flow in that general area.
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And so then we were able to suggest, given
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the calcifications, this sort of irregular
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flow going to it, that this was most likely
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going to be a partially calcified fibroid.
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Your differential is still going
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to be an endometrial malignancy.
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She was 42, so she's a little bit young
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to have that, but certainly possible.
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Either way, though, you need the gynecologic consult to figure out what this is.
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It did go in to take this out
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given her abnormal bleeding history,
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and it was an intracavitary fibroid.
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So always something to think about, especially
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if it looks a little, a little bit atypical
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from what we've been seeing — you know, a lot of
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calcification, a lot of weird blood flow to it.
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That's another thing to think
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about is an intracavitary fibroid.
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