ADENOMYOSIS <br />MERCURY IMAGING INSTITUTE <br />SCO 172-173 SEC 9C  CHANDIGARH<br />MERCURY IMAGING CENTRE <br />SCO 16...
DIFFERENTIATE                           ADENOMYOSIS                                      FROM LEIOMYOMA<br />
FEATURES OF ADENOMYOSIS <br />Echogenecity of mass---------- Hyperechoic<br />Borders of the mass------------ill -defined<...
FEATURES OF   LEIOMYOMA  <br />Echogenecity of mass---------- Hypoechoic<br />Borders of the mass------------Defined<br />...
Present case ...................... <br /><ul><li>Bulky uterus with lobulated outline
Heterogenous pattern of the Myometrium
Intramyometrialpeneteratingvascularity.
Congested  venous system.
Focal defined hypoechoic areas – Leiomyomas
G sac – 5wks with                    ? Viability----Follow up advised . </li></li></ul><li>INCREASED INTRAMYOMETRIAL   VAS...
CONGESTED TORTUOUS VESSELS – INTRAMYOMETRIAL . PENETERATING PATTERN<br />FOCAL HYPOECHOIC AREAS APPRECIATED IN THE MYOMETR...
G SAC WITH NO FETAL NODE/ NO YOLK SAC. CORROBORATES WITH POG 5WKS ODAYS ......FOLLOW UP FOR VIABILITY  <br />HETEROGENOUS ...
MAGNIFIED VIEW OF THE G SAC  <br />SINGLE LINER <br />ADENOMYOSIS CAN PREDISPOSE TO INTRAMYOMETRIAL ECTOPIC PREGNANCY <br />
BULKY UTERUS  WITH LOBULATED OUTLINE  <br />
PENETERATING   PATTERN OF THE VASCULATURE<br />
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Pregnancy with adenomyosis and leiomyoma with component of pelvic congestion

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Pregnancy with adenomyosis and leiomyoma with component of pelvic congestion

  1. 1. ADENOMYOSIS <br />MERCURY IMAGING INSTITUTE <br />SCO 172-173 SEC 9C CHANDIGARH<br />MERCURY IMAGING CENTRE <br />SCO 16-17 SEC 20D CHANDIGARH<br />22 YEAR OLD FEMALE WITH POG OF 5WKS . EPISODIC PAIN IN THE LOWER ABDOMEN.<br />
  2. 2. DIFFERENTIATE ADENOMYOSIS FROM LEIOMYOMA<br />
  3. 3. FEATURES OF ADENOMYOSIS <br />Echogenecity of mass---------- Hyperechoic<br />Borders of the mass------------ill -defined<br />Vascularity of the lesion------- Penetrating <br />Size of uterus---------------------Bulky with asymmetrical lobulations ( anterior and posetrior). <br />Junctional zone-------------------Thick. ( >8mm ( 8-12mm) >12mm) ( MR sagittal plane T2w sequence gives best assesment of junctional zone)<br />Subendometrial / Intramyometrial cysts -Present .<br />
  4. 4. FEATURES OF LEIOMYOMA <br />Echogenecity of mass---------- Hypoechoic<br />Borders of the mass------------Defined<br />Vascularity of the lesion------- Peripheral <br />Junctional zone------------------- Normal.<br />Subendometrial / Intramyometrial cysts- Not present . <br />
  5. 5. Present case ...................... <br /><ul><li>Bulky uterus with lobulated outline
  6. 6. Heterogenous pattern of the Myometrium
  7. 7. Intramyometrialpeneteratingvascularity.
  8. 8. Congested venous system.
  9. 9. Focal defined hypoechoic areas – Leiomyomas
  10. 10. G sac – 5wks with ? Viability----Follow up advised . </li></li></ul><li>INCREASED INTRAMYOMETRIAL VASCULATURE <br />PENETERATING PATTERN <br />
  11. 11. CONGESTED TORTUOUS VESSELS – INTRAMYOMETRIAL . PENETERATING PATTERN<br />FOCAL HYPOECHOIC AREAS APPRECIATED IN THE MYOMETRIUM WITH DEFINED BORDERS – CORROBORATIVE WITH SMALL LEIOMYOMA.<br />
  12. 12. G SAC WITH NO FETAL NODE/ NO YOLK SAC. CORROBORATES WITH POG 5WKS ODAYS ......FOLLOW UP FOR VIABILITY <br />HETEROGENOUS ECHOPATTERN OF THE MYOMETRIUM <br />
  13. 13. MAGNIFIED VIEW OF THE G SAC <br />SINGLE LINER <br />ADENOMYOSIS CAN PREDISPOSE TO INTRAMYOMETRIAL ECTOPIC PREGNANCY <br />
  14. 14. BULKY UTERUS WITH LOBULATED OUTLINE <br />
  15. 15. PENETERATING PATTERN OF THE VASCULATURE<br />
  16. 16. VALSALVAE ---- Tortuos venous channels- normal response. – Pregnanacy with adenomyosis – Associated component of pelvic congestion.<br />
  17. 17. LOW RESISTANCE ARTERIAL TREE.- PREGNANT STATE WITH ASSOCIATED ADENOMYOSIS<br />
  18. 18. ECTOPIC ENDOMETRIAL GLAND WITH SMOOTH MUSCLE HYPERPLASIA<br />
  19. 19. LESSON LEARNT<br />Differentiate between Adenomyosis and Leiomyoma.<br />Appreciate peneterating pattern form the Peripheral arterial tree.<br />Differentiate focal from diffuse form of the adenomyosis. <br />

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