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Partial Septate on US

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Our next case is of a 24-year-old

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who comes in with pelvic pain.

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We'll start here with a transverse

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cine clip of the uterus.

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You can see some roiling

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bowel contents over here.

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We started up at the fundus, so this

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is going to be your uterus right here.

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We have these two little echogenic areas

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right here, so it suggests that there's

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two separate, almost horns in this case.

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We're seeing increased through transmission

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behind them because endometrium is a lot

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of fluid, fluid-filled structures and

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vascularity, and then they fuse right here.

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So now we have one endometrium all the way

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down to the cervical region, one cervix,

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one cervix as we follow it all the way down.

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Scroll back up through it with my mouse out of

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the way here, and we see one endometrial canal

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in the cervix, and then in the lower uterine

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segment as we come up towards the fundus.

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They sort of split or diverge right here.

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So it's really hard, again, to get a fundal

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view of a uterus on a transvaginal ultrasound,

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so you really are reliant on your 3D imaging.

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So that's what we have here.

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This is where they were acquiring

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the 3D imaging, and this is what

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we ended up getting right here.

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So, here is your endometrial cavity,

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and you can see a bit of a dip here.

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Right here, and you have a fundal contour

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out here, which looks pretty normal; it dips

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in just a little bit, but not very much.

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If you can measure on these, it's nice to

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measure how far those dips are, but you can also

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see that this is a partial septate, borderline

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arcuate uterus in this particular case.

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So you can see on the 3D right here, the contour

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is fairly normal right here, and sort of mimics

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right here on the endometrium right here.

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We do not have a complete septate

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all the way down right here.

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So this is either an arcuate, borderline

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partial septate uterus right here.

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So treatment for these, again, is a resection

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of the septum if there definitely is

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one; if they have a history of repeated

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miscarriages, and future pregnancies should

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be able to implant and grow normally.

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So differential, again, for a case like

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this would have been a bicornuate

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uterus, but your focus is on the fundal

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contour here, which is completely normal.

Report

Faculty

Kathryn McGillen, MD

Assistant Professor of Radiology, Medical Director of Ultrasound

Penn State University Milton S Hershey Medical Center

Tags

Uterus

Ultrasound

Gynecologic (GYN)

Body

Acquired/Developmental

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