0:02

So our first case is a 48-year-old

0:03

patient who comes in with heavy menses.

0:07

We're going to start with the transabdominal

0:08

view of the uterus on sagittal imaging.

0:11

You'll note that the bladder isn't filled in

0:13

this particular case. You have a little bit of

0:15

bladder right here that's filling, and this is

0:17

because we do this on all of ours per protocol.

0:19

We do transabdominal in case the uterus is

0:21

so large, the ovaries are very high that

0:23

we can't see them via the transvaginal view.

0:26

13 00:00:26,675 --> 00:00:29,565 And I think in this case, we'll go

0:29

to the transvaginal in just a moment.

0:31

We can already see there are

0:33

multiple lesions in this uterus.

0:35

We have our bright stripe here in the

0:36

middle, and then you have this dark,

0:39

heterogeneous lesion with some shadowing at

0:42

the margins of it. Another lesion over here.

0:45

Another lesion here.

0:50

So then we'll move to the transvaginal

0:52

view, which gives you some

0:53

hopefully prettier pictures as well.

0:57

And again, classic fibroids.

0:59

We have one here in the lower uterine segment.

1:00

It's heterogeneous.

1:02

It has that shadowing

1:03

occurring at the margins of it.

1:04

You can see the mass effect upon the endometrium

1:06

right here from this fibroid back here.

1:09

And you can certainly see this one is shadowing

1:11

enough that it's difficult to see the tissue

1:13

behind to judge what's going on back there.

1:18

This one does have mass effects on the

1:20

endometrium right here. Sometimes with

1:22

ultrasound, it can be told if it's just mass

1:24

effect or truly a submucosal component.

1:27

You want to look to see if there's myometrial

1:28

tissue in between the fibroid and endometrium

1:31

and that way you can tell for sure,

1:33

but sometimes it's too difficult and you have

1:35

to say this may have a submucosal component.

1:38

A classic appearance of a fibroid here,

1:40

another small one here anteriorly.

1:45

So all fairly classic fibroids, and then

1:47

one more back here, lots of fibroids

1:50

in this uterus.