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This is an MRI of the abdomen and pelvis in

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a patient with an abnormal pelvic ultrasound

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and significant vaginal bleeding in the

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context of a positive home pregnancy test.

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Her initial pelvic ultrasound

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evaluation was limited by the

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presence of numerous uterine fibroids.

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which we can see on this coronal T2-weighted

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image as multiple well-circumscribed T2 hypo-

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intense lesions within the uterine myometrium.

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Axial T2-weighted images of the

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abdomen and pelvis are present

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on the left side of the screen.

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Again, we see multiple T2

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dark uterine fibroids present.

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As we scroll inferiorly, we see the endometrial

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cavity, which is T2 bright, and a small

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amount of surrounding junctional zone.

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We also see a uterine fibroid, which

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is somewhat exophytic and is likely

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undergoing hyaline degeneration internally.

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In the region of the cervix, we see

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a heterogeneously T2 hyperintense

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lesion with a central cystic focus.

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This is a gestational sac centered within

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the cervix with surrounding early chorionic

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proliferation and placental development.

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End.

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The T2 dark focus that we see within

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a gestational sac is the embryo.

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On the coronal T2-weighted images, again, we see

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multiple well-circumscribed uterine fibroids.

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In the region of the cervix, we see

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heterogeneously T2 hyperintense tissue

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with a central cystic focus, which we now

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know is the amniotic sac or gestational sac.

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We see the embryo within the central aspect

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of the gestational sac, and again, this

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heterogeneous tissue within the cervix

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is early chorionic proliferation

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and placental development.

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Lastly, let's evaluate the sagittal T2-

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weighted images of the pelvis for this patient.

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Again, we see multiple uterine

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fibroids with a posteriorly located and

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mildly compressed endometrial cavity.

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Within the region of the cervix, it's very

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difficult on the sagittal to define the

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anterior and posterior lip, although perhaps

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we see a bit of the cervical canal here.

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The bulk of this early chorionic tissue is

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centered within the posterior lip of the

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cervix, with the gestational sac centrally.

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This patient is at significant risk for

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severe bleeding in the context of this ectopic

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pregnancy, which is cervical in location.

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This patient was taken to surgery,

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which confirmed a diagnosis

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of cervical ectopic pregnancy.