Interactive Transcript
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Our next case is of a 50-year-old
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again for an IUD check.
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I'm just going to start at
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this point with our cine clips.
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This is a sagittal uterus.
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We'll let you know that this is a
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retroverted and retroflexed uterus.
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Those again are very hard
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to get in a single plane.
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Sometimes even sagittally it can be difficult
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and sometimes it can be near impossible
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to get it in a good transverse plane.
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So that's why it looks,
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can look a little tricky here.
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So as we're scrolling through this
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one, we can see some IUD for sure.
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I see shadowing down here.
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It's definitely an IUD.
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We have a fibroid right here,
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but I do not see an IUD up here closer
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to the fundus where it should be.
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We'll go to our, you know, quote-unquote
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transverse plane, which is as best as we could get.
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And you can already see there's
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uterus endometrium over here
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and there's shadowing over here.
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I don't know where this structure is,
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but that doesn't look okay.
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So we follow it up towards the fundus.
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Again, I see nothing where it should be.
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There's no IUD up towards the fundus.
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Fibroid here, fibroid here.
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Lots going on in this busy uterus.
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And some IUD way over here.
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Another fibroid coming into view.
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Really hard to tell until we get
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down to here where we definitely see
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that classic shadowing from the IUD.
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So I don't know exactly where this is again.
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I do know that it's
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extraordinarily abnormal, however.
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So if we go to our 3D imaging here at the end.
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Here's our 3D imaging.
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Remembering this is a retroverted, retroflexed.
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3D still works for them.
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You might have to play around with it a little bit
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more, but you can get diagnostic images from it.
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So this is flipped.
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Here's the fundus down here in this
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particular case, and here's your IUD.
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So that's that long body of it that we were
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seeing, that shadowing, really low right here.
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The left arm is over here,
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the right arm is over here.
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So now I understand exactly how
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that IUD is positioned right there.
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I can't tell definitively if it's embedded,
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but based off of this, anything I'm worried
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about is either going to be the body right
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here, and maybe that right arm. The left
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arm looks like it's going to be okay.
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So with that in mind, I'll go back to
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my cine clips one more time to try and
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figure out exactly what's going on.
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So we'll do that here.
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This is another transverse cine
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clip that they took again later on.
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We're going to follow it again down here.
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We can follow this over here, endometrium over
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here, and then this, paraovarian cyst right
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there, is not in the endometrium right here.
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So I think now that we know what's going
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on a little bit better based off of
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that 3D, we can follow this up again.
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We can try and follow those arms to see
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what is embedded in these particular cases.
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So again, I think that 3D not only helps
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because you can visualize it better, but
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now you can go back to your cine clips
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and try and decide whether something is
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embedded or not, and if so, how much.
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So it can be a little bit difficult when that
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endometrium, like in this case, is really
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super thin to figure out what's going on.
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