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Second/Third Trimester CT

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This is a CT of the abdomen and pelvis in

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a patient with a third-trimester pregnancy.

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Now I'd like to point out that

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the portal veins and the abdominal

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vasculature are bright in these images.

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We have given intravenous iodinated CT

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contrast to this patient because she

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was imaged in the context of trauma.

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This is the gravid uterus, and similar to

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the MR images that we looked at, we can

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see the layer of myometrium throughout.

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This heterogeneously enhancing structure

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anteriorly is the placenta, and we can see

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the fetus here again in cephalic presentation.

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On the sagittal images, we

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can also evaluate the cervix.

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This is the anterior lip and posterior lip.

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The cervical canal does not have any fluid

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within it, and the cervical os is closed.

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I'd like to point out some of the features

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of the fetus that are more apparent

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on the CT than they may have been on

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some of the MR images that we looked at.

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We can very clearly see this hypodense layer

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of fat within the fetal subcutaneous tissues.

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CT is also great for evaluation

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of the fetal osseous structures.

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And so they'll appear very

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bright, hyperdense on CT.

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In the context of trauma, it is important to

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also evaluate the fetal osseous structures

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if there's evidence of maternal injury.

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We do sometimes detect fetal

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fractures on CT as well.

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This is a coronal CT image of the

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abdomen and pelvis in the same patient.

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Again, we can see the enlarged gravid uterus.

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This heterogeneously enhancing structure

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is the predominantly anterior placenta.

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And again, we see the fetus in

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cephalic presentation, head down.

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I'd also like to point out again the lateral

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displacement of the bowel and some of the

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abdominal viscera by the enlarged uterus.

Report

Faculty

Erin Gomez, MD

Assistant Professor of Radiology

Johns Hopkins Hospital

Tags

Women's Health

Uterus

Ovaries

Gynecologic (Gyn)

Gynecologic (GYN)

Genitourinary (GU)

Cervix

CT

Body

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