This document discusses benign pelvic diseases in females, with a focus on Mullerian duct anomalies (MDAs). It describes the normal development of the Mullerian ducts and various types of MDAs that can occur due to interruptions during development, including uterine anomalies like bicornuate, septate, and arcuate uteri. Imaging modalities for evaluating MDAs are discussed. MDAs are often associated with renal and other anomalies. The document provides detailed descriptions and images of various MDA classifications.
Doppler determinants in ovarian tumorsAkshay Dhina
This document summarizes a study on using Doppler ultrasound to differentiate between benign and malignant ovarian tumors. The study found that using color Doppler and spectral Doppler analysis improved sensitivity from 53% to 82% and specificity from 83% to 94%, compared to ultrasound alone. Key findings included:
- 92% of malignant tumors showed neovascularization compared to 42% of benign tumors.
- An resistive index of <0.6 and peak systolic velocity index of <0.8 occurred in 92% of malignant versus 6.4% of benign tumors.
- Location of blood flow (central vs. peripheral) helped differentiate solid benign and malignant tumors.
The study concluded Doppler ultrasound provides important additional information over ultrasound alone
This document discusses Bronchus-associated lymphoid tissue (BALT) lymphoma, which is a rare subtype of primary non-Hodgkin lymphoma that occurs in the lung. BALT lymphoma has nonspecific imaging findings including nodules, masses, consolidation and ground-glass opacity. Intrathoracic lymphadenopathy is usually absent. Treatment involves surgical resection, chemotherapy, radiation or immunotherapy, and survival rates are relatively high as the disease is often diagnosed before spreading. The document also provides details on the pathogenesis, clinical presentation, imaging appearance and differential diagnosis of BALT lymphoma.
This document provides information on endometriosis from Dr. Shashwat Jani, including:
- Definitions and descriptions of endometriosis, including common sites of lesions.
- Theories on the causes and pathophysiology of endometriosis such as retrograde menstruation and coelomic metaplasia.
- Clinical features like pelvic pain and infertility.
- Diagnostic methods including clinical exam, imaging, biomarkers, and laparoscopy - the gold standard.
- Staging and treatment approaches are also briefly covered.
A 18-year-old female presented with a mobile swelling in her right breast for 8 months. Ultrasound revealed a well-defined encapsulated mass in the retroareolar region of the right breast with whorled appearance, posterior acoustic enhancement, and tiny specks of calcification. Color Doppler showed non-chaotic vascularity within the mass and at the periphery. The mass was diagnosed as a fibroadenoma based on its characteristic ultrasound features.
gynaecology.Benign tumor of the uterus.(dr.sundus)student
Benign disease of the uterus includes fibroids, adenomyosis, and uterine polyps. Fibroids are non-cancerous tumors that form in the uterus and are very common. They can cause heavy bleeding and pain. Uterine polyps are overgrowths of tissue in the uterus that can also cause abnormal bleeding. While many women do not experience symptoms, fibroids and polyps sometimes require treatment such as surgery to remove them.
Endometriosis is the presence of endometrial tissue outside the uterus, most commonly found on the ovaries, pelvic peritoneum, and ligaments. It affects 6-10% of women and is a common cause of infertility and pelvic pain. Diagnosis is typically made by laparoscopy where lesions are visualized and biopsied. Treatment aims to reduce pain and fertility issues through hormonal suppression or surgery to remove lesions. Complications can include infertility, pregnancy issues, intestinal obstruction, and in rare cases, malignant transformation of lesions.
Doppler determinants in ovarian tumorsAkshay Dhina
This document summarizes a study on using Doppler ultrasound to differentiate between benign and malignant ovarian tumors. The study found that using color Doppler and spectral Doppler analysis improved sensitivity from 53% to 82% and specificity from 83% to 94%, compared to ultrasound alone. Key findings included:
- 92% of malignant tumors showed neovascularization compared to 42% of benign tumors.
- An resistive index of <0.6 and peak systolic velocity index of <0.8 occurred in 92% of malignant versus 6.4% of benign tumors.
- Location of blood flow (central vs. peripheral) helped differentiate solid benign and malignant tumors.
The study concluded Doppler ultrasound provides important additional information over ultrasound alone
This document discusses Bronchus-associated lymphoid tissue (BALT) lymphoma, which is a rare subtype of primary non-Hodgkin lymphoma that occurs in the lung. BALT lymphoma has nonspecific imaging findings including nodules, masses, consolidation and ground-glass opacity. Intrathoracic lymphadenopathy is usually absent. Treatment involves surgical resection, chemotherapy, radiation or immunotherapy, and survival rates are relatively high as the disease is often diagnosed before spreading. The document also provides details on the pathogenesis, clinical presentation, imaging appearance and differential diagnosis of BALT lymphoma.
This document provides information on endometriosis from Dr. Shashwat Jani, including:
- Definitions and descriptions of endometriosis, including common sites of lesions.
- Theories on the causes and pathophysiology of endometriosis such as retrograde menstruation and coelomic metaplasia.
- Clinical features like pelvic pain and infertility.
- Diagnostic methods including clinical exam, imaging, biomarkers, and laparoscopy - the gold standard.
- Staging and treatment approaches are also briefly covered.
A 18-year-old female presented with a mobile swelling in her right breast for 8 months. Ultrasound revealed a well-defined encapsulated mass in the retroareolar region of the right breast with whorled appearance, posterior acoustic enhancement, and tiny specks of calcification. Color Doppler showed non-chaotic vascularity within the mass and at the periphery. The mass was diagnosed as a fibroadenoma based on its characteristic ultrasound features.
gynaecology.Benign tumor of the uterus.(dr.sundus)student
Benign disease of the uterus includes fibroids, adenomyosis, and uterine polyps. Fibroids are non-cancerous tumors that form in the uterus and are very common. They can cause heavy bleeding and pain. Uterine polyps are overgrowths of tissue in the uterus that can also cause abnormal bleeding. While many women do not experience symptoms, fibroids and polyps sometimes require treatment such as surgery to remove them.
Endometriosis is the presence of endometrial tissue outside the uterus, most commonly found on the ovaries, pelvic peritoneum, and ligaments. It affects 6-10% of women and is a common cause of infertility and pelvic pain. Diagnosis is typically made by laparoscopy where lesions are visualized and biopsied. Treatment aims to reduce pain and fertility issues through hormonal suppression or surgery to remove lesions. Complications can include infertility, pregnancy issues, intestinal obstruction, and in rare cases, malignant transformation of lesions.
This document discusses benign cysts and tumors of the ovaries. It describes the main types of ovarian cysts which include follicular cysts, corpus luteum cysts, dermoid cysts, and endometriomas. It also outlines the two major classifications of ovarian tumors - non-epithelial tumors including germ cell tumors and stromal tumors, and epithelial tumors. Within these classifications, it provides details on specific tumor types such as mature cystic teratoma, dysgerminoma, granulosa cell tumor, and serous tumor. Risk factors, symptoms, staging, treatment and other considerations for ovarian cysts and tumors are summarized.
The document provides information on normal ovaries and ovarian masses. It discusses:
1. The typical size of normal ovaries and factors that can affect size.
2. Risks of ovarian neoplasms - a woman has a 5-10% lifetime risk of surgery for a suspected ovarian mass, of which 13-21% will be malignant.
3. Differential diagnosis of adnexal masses varies with age, with masses in pre-menarchal/post-menopausal women considered highly abnormal.
The document discusses tumors of the female genital tract in dogs. It notes that mammary tumors are the second most common tumors in dogs, and that early spaying protects against mammary cancer development later in life. The pathogenesis of mammary tumors involves hormonal influences on mammary epithelial cell proliferation from prolonged exposure to synthetic progestins, which can lead to genetic errors and tumor development. Clinical signs include the presence of masses in mammary tissue that may appear and remain static or grow rapidly. Diagnosis involves physical examination, biopsy, and staging to determine if the cancer has metastasized. Common tumor types are carcinomas and sarcomas, with surgery being a main treatment along with possible chemotherapy or radiation therapy for advanced cases.
Pre-Cancerous diseases of female reproductive organsEneutron
1. Benign and pre-cancerous cervical diseases are characterized by epithelial dysplasia and abnormal cell proliferation and differentiation in the cervix. Common risk factors include HPV infection, early sexual activity, multiple partners, and hormonal imbalances.
2. Precancerous cervical conditions are classified histologically from mild to severe dysplasia. Diagnosis involves cytology, colposcopy, and biopsy of abnormal lesions. Treatment aims to eliminate pathological processes through conservative or surgical methods.
3. Prevention involves vaccination against HPV, like Cervarix, administered in 3 doses over 6 months. Regular screening also allows for early detection and treatment before cancer develops.
Uterine leiomyomas, or fibroids, are benign smooth muscle tumors that are the most common pelvic tumor in women. Fibroids can be described by their location in the uterus and may cause abnormal uterine bleeding, pelvic pressure and pain, or reproductive dysfunction. Symptoms are often relieved at menopause.
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
1) The document discusses the normal anatomy of the breast including ducts, lobules, and changes that occur during puberty, pregnancy, and menopause.
2) It also covers developmental abnormalities, inflammatory conditions, benign and malignant tumors of the breast including fibroadenomas, cystosarcoma phyllodes, ductal carcinoma in situ, invasive ductal carcinoma and Paget's disease of the nipple.
3) The pathology of the male breast is also summarized, mainly being gynecomastia which is a benign increase in breast tissue, and carcinoma which is rare but can occur.
Endometriosis is a non-neoplastic condition where functional ectopic endometrial tissue grows outside the uterus, influenced by ovarian hormones before menopause. Common sites include ovaries, pelvic cavity, uterine ligaments, tubes, and rectovaginal septum. Symptoms include infertility, pelvic pain, dysmenorrhea, dyspareunia, and dysuria. Microscopically, lesions appear as reddish-blue or yellowish-brown nodules up to 2 cm containing endometrial glands and stroma. Theories for its pathogenesis include retrograde menstruation, metaplasia of coelomic epithelium, and lymphatic or vascular spread from the uterus
Benign cervical diseases are common but malignancy must be ruled out. Cervical cancer develops from premalignant cervical intraepithelial neoplasia over years. Screening for premalignant cervical disease significantly reduces cervical cancer deaths by detecting cervical intraepithelial neoplasia, which is then diagnosed and treated through colposcopy.
This document discusses ultrasound findings in early pregnancy that can help diagnose conditions like ectopic pregnancy and diagnose fetal viability. It describes what ultrasound findings indicate a normal intrauterine pregnancy versus an abnormal pregnancy or early pregnancy failure. Key findings discussed include the gestational sac, yolk sac, embryonic cardiac activity, subchorionic hemorrhage, and retained products of conception. Diagnosis of conditions is supported by quantitative measures like gestational sac size and heart rate in relation to crown-rump length.
Uterine polyps and fibroids are common benign uterine tumors. Uterine polyps can be endometrial, fibroid, adenomyomatous, or placental in origin. They typically present with menorrhagia, metrorrhagia, or postmenopausal bleeding. Diagnosis is usually made by ultrasound, and polyps can be removed by D&C or hysteroscopy. Fibroids are the most common benign tumors in women. They are estrogen dependent and present with heavy menstrual bleeding, infertility, pain, or an abdominal mass. Treatment involves medical therapy, myomectomy or hysterectomy depending on symptoms. Adenomyosis involves endometrial tissue within the myometrial
This document discusses various types of benign ovarian cysts and tumors, including functional cysts such as follicular cysts and corpus luteal cysts, inflammatory cysts such as tubo-ovarian abscesses, germ cell tumors like dermoid cysts, epithelial cysts such as serous and mucinous cystadenomas, and solid benign tumors including Brenner tumors, fibromas, and thecomas. It provides details on the characteristics, causes, diagnostic criteria, and typical treatment for each type.
Benign diseases of the uterus and cervixMagda Helmi
Benign diseases of the uterus and cervix are common problems seen in gynecological clinics. The most common myometrial problem is uterine fibroids, which are benign tumors originating from the uterine smooth muscle layer. Other common benign uterine conditions addressed include cervical ectropion, cervical stenosis, endometrial polyps, and Asherman's syndrome. These conditions can present with symptoms like abnormal bleeding or pain and are typically diagnosed by ultrasound, hysteroscopy or dilation and curettage. Treatment options depend on the specific condition but may include medication, surgical procedures, or hormone therapy.
Uterine sarcomas are rare, aggressive cancers that arise from the muscular or connective tissues of the uterus. The main types are leiomyosarcomas, endometrial stromal sarcomas, and malignant mixed müllerian tumors. Uterine sarcomas commonly spread through the bloodstream to vital organs like the lungs and liver. Patients typically present with abnormal vaginal bleeding and abdominal pain. Diagnosis is made through histological examination of tissue samples obtained through procedures like uterine curettage.
This document discusses benign ovarian tumors, including functional ovarian cysts and benign neoplastic ovarian tumors. It describes the main types of functional cysts such as follicular, lutein and hemorrhagic cysts. It also outlines the main types of benign neoplastic ovarian tumors, including epithelial tumors, sex cord-stromal tumors, germ cell tumors and mixed tumors. The diagnosis, management and treatment options for different types of benign ovarian tumors are provided.
This document discusses benign and malignant breast tumors. Benign tumors include fibroadenoma, intraductal papilloma, and phyllodes tumor. Malignant tumors include in situ carcinomas, invasive ductal carcinoma (the most common), invasive lobular carcinoma, and Paget's disease. Key microscopic features are described, such as the characteristic "Indian file" pattern of invasive lobular carcinoma and large tumor cells within epidermal clefts in Paget's disease.
Uterine leiomyomas, or fibroids, are benign smooth muscle tumors that arise from the uterus. They are very common, affecting approximately 25% of women. Symptoms vary depending on the size and location of the fibroids but can include heavy menstrual bleeding, pelvic pain and pressure, and pregnancy complications. Treatment options include observation for small asymptomatic fibroids, medical management to control symptoms, or various surgical procedures like myomectomy or hysterectomy to remove fibroids.
Presentation1.pptx, radilogical imaging of ovarian lesions.Abdellah Nazeer
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that is a common complication of sexually transmitted diseases. It can cause long-term issues like chronic pelvic pain, infertility, and ectopic pregnancy due to scarring and adhesions. PID includes conditions like endometritis, salpingitis, and tubo-ovarian abscess. Prompt diagnosis and treatment are important to prevent life-threatening complications due to the varied presentation and sometimes difficultly in detection of PID. Radiological imaging can help identify signs of PID and related conditions like tubo-ovarian abscesses.
Leiomyoma, commonly known as uterine fibroids, are benign smooth muscle tumors of the uterus that are the most common tumors of the female pelvis. They occur most frequently in women during their childbearing years. While the exact causes are unknown, risk factors include high estrogen levels. Leiomyomas can be classified based on their location within the uterus as submucosal, subserosal, or intramural. Magnetic resonance imaging is the most accurate imaging technique for detecting and classifying leiomyomas. Treatment options depend on factors such as a patient's age, parity, symptoms, and the size and location of the fibroids and include conservative approaches, medications, uterine artery embolization,
Adenomyosis is a benign condition where endometrial tissue grows into the myometrium. It causes the uterus to enlarge asymmetrically, especially on the posterior wall. Women with adenomyosis typically experience heavy menstrual bleeding and painful periods that can occur throughout the month. Ultrasound and MRI can detect adenomyosis by showing cysts in the thickened myometrium and an indistinct endomyometrial junction. Treatment depends on a woman's age and fertility desires, ranging from medication like NSAIDs and oral contraceptives to hysterectomy for older, parous women.
The document discusses the ultrasound and MRI appearance of the normal endometrium and various endometrial pathologies including polyps, hyperplasia, and carcinoma. It describes how the endometrium changes in appearance throughout the menstrual cycle in pre- and postmenopausal women. Endometrial polyps appear as focal masses or thickening on ultrasound and low signal masses on MRI. Hyperplasia is suggested by endometrial thickness over 10mm. Endometrial carcinoma demonstrates irregular thickening or an intracaity mass and can invade the myometrium or cervix in advanced stages. The 2009 FIGO staging system for endometrial cancer is outlined. MRI is useful for staging by evaluating myometrial
1) STI's are common among adolescents in the United States, with about 24% of adolescent females having evidence of at least one of the main STI's. Left untreated, STI's can cause infertility and other serious health issues.
2) Common STI's include chlamydia, gonorrhea, trichomoniasis, HPV, HSV-2, and syphilis. Symptoms and signs vary depending on the specific infection, but may include abnormal discharge, ulcers, rashes, or pelvic pain. Many infections can also be asymptomatic.
3) Screening and treatment guidelines exist for various STI's. Regular screening is recommended for sexually active adolescents and young
This document discusses benign cysts and tumors of the ovaries. It describes the main types of ovarian cysts which include follicular cysts, corpus luteum cysts, dermoid cysts, and endometriomas. It also outlines the two major classifications of ovarian tumors - non-epithelial tumors including germ cell tumors and stromal tumors, and epithelial tumors. Within these classifications, it provides details on specific tumor types such as mature cystic teratoma, dysgerminoma, granulosa cell tumor, and serous tumor. Risk factors, symptoms, staging, treatment and other considerations for ovarian cysts and tumors are summarized.
The document provides information on normal ovaries and ovarian masses. It discusses:
1. The typical size of normal ovaries and factors that can affect size.
2. Risks of ovarian neoplasms - a woman has a 5-10% lifetime risk of surgery for a suspected ovarian mass, of which 13-21% will be malignant.
3. Differential diagnosis of adnexal masses varies with age, with masses in pre-menarchal/post-menopausal women considered highly abnormal.
The document discusses tumors of the female genital tract in dogs. It notes that mammary tumors are the second most common tumors in dogs, and that early spaying protects against mammary cancer development later in life. The pathogenesis of mammary tumors involves hormonal influences on mammary epithelial cell proliferation from prolonged exposure to synthetic progestins, which can lead to genetic errors and tumor development. Clinical signs include the presence of masses in mammary tissue that may appear and remain static or grow rapidly. Diagnosis involves physical examination, biopsy, and staging to determine if the cancer has metastasized. Common tumor types are carcinomas and sarcomas, with surgery being a main treatment along with possible chemotherapy or radiation therapy for advanced cases.
Pre-Cancerous diseases of female reproductive organsEneutron
1. Benign and pre-cancerous cervical diseases are characterized by epithelial dysplasia and abnormal cell proliferation and differentiation in the cervix. Common risk factors include HPV infection, early sexual activity, multiple partners, and hormonal imbalances.
2. Precancerous cervical conditions are classified histologically from mild to severe dysplasia. Diagnosis involves cytology, colposcopy, and biopsy of abnormal lesions. Treatment aims to eliminate pathological processes through conservative or surgical methods.
3. Prevention involves vaccination against HPV, like Cervarix, administered in 3 doses over 6 months. Regular screening also allows for early detection and treatment before cancer develops.
Uterine leiomyomas, or fibroids, are benign smooth muscle tumors that are the most common pelvic tumor in women. Fibroids can be described by their location in the uterus and may cause abnormal uterine bleeding, pelvic pressure and pain, or reproductive dysfunction. Symptoms are often relieved at menopause.
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
1) The document discusses the normal anatomy of the breast including ducts, lobules, and changes that occur during puberty, pregnancy, and menopause.
2) It also covers developmental abnormalities, inflammatory conditions, benign and malignant tumors of the breast including fibroadenomas, cystosarcoma phyllodes, ductal carcinoma in situ, invasive ductal carcinoma and Paget's disease of the nipple.
3) The pathology of the male breast is also summarized, mainly being gynecomastia which is a benign increase in breast tissue, and carcinoma which is rare but can occur.
Endometriosis is a non-neoplastic condition where functional ectopic endometrial tissue grows outside the uterus, influenced by ovarian hormones before menopause. Common sites include ovaries, pelvic cavity, uterine ligaments, tubes, and rectovaginal septum. Symptoms include infertility, pelvic pain, dysmenorrhea, dyspareunia, and dysuria. Microscopically, lesions appear as reddish-blue or yellowish-brown nodules up to 2 cm containing endometrial glands and stroma. Theories for its pathogenesis include retrograde menstruation, metaplasia of coelomic epithelium, and lymphatic or vascular spread from the uterus
Benign cervical diseases are common but malignancy must be ruled out. Cervical cancer develops from premalignant cervical intraepithelial neoplasia over years. Screening for premalignant cervical disease significantly reduces cervical cancer deaths by detecting cervical intraepithelial neoplasia, which is then diagnosed and treated through colposcopy.
This document discusses ultrasound findings in early pregnancy that can help diagnose conditions like ectopic pregnancy and diagnose fetal viability. It describes what ultrasound findings indicate a normal intrauterine pregnancy versus an abnormal pregnancy or early pregnancy failure. Key findings discussed include the gestational sac, yolk sac, embryonic cardiac activity, subchorionic hemorrhage, and retained products of conception. Diagnosis of conditions is supported by quantitative measures like gestational sac size and heart rate in relation to crown-rump length.
Uterine polyps and fibroids are common benign uterine tumors. Uterine polyps can be endometrial, fibroid, adenomyomatous, or placental in origin. They typically present with menorrhagia, metrorrhagia, or postmenopausal bleeding. Diagnosis is usually made by ultrasound, and polyps can be removed by D&C or hysteroscopy. Fibroids are the most common benign tumors in women. They are estrogen dependent and present with heavy menstrual bleeding, infertility, pain, or an abdominal mass. Treatment involves medical therapy, myomectomy or hysterectomy depending on symptoms. Adenomyosis involves endometrial tissue within the myometrial
This document discusses various types of benign ovarian cysts and tumors, including functional cysts such as follicular cysts and corpus luteal cysts, inflammatory cysts such as tubo-ovarian abscesses, germ cell tumors like dermoid cysts, epithelial cysts such as serous and mucinous cystadenomas, and solid benign tumors including Brenner tumors, fibromas, and thecomas. It provides details on the characteristics, causes, diagnostic criteria, and typical treatment for each type.
Benign diseases of the uterus and cervixMagda Helmi
Benign diseases of the uterus and cervix are common problems seen in gynecological clinics. The most common myometrial problem is uterine fibroids, which are benign tumors originating from the uterine smooth muscle layer. Other common benign uterine conditions addressed include cervical ectropion, cervical stenosis, endometrial polyps, and Asherman's syndrome. These conditions can present with symptoms like abnormal bleeding or pain and are typically diagnosed by ultrasound, hysteroscopy or dilation and curettage. Treatment options depend on the specific condition but may include medication, surgical procedures, or hormone therapy.
Uterine sarcomas are rare, aggressive cancers that arise from the muscular or connective tissues of the uterus. The main types are leiomyosarcomas, endometrial stromal sarcomas, and malignant mixed müllerian tumors. Uterine sarcomas commonly spread through the bloodstream to vital organs like the lungs and liver. Patients typically present with abnormal vaginal bleeding and abdominal pain. Diagnosis is made through histological examination of tissue samples obtained through procedures like uterine curettage.
This document discusses benign ovarian tumors, including functional ovarian cysts and benign neoplastic ovarian tumors. It describes the main types of functional cysts such as follicular, lutein and hemorrhagic cysts. It also outlines the main types of benign neoplastic ovarian tumors, including epithelial tumors, sex cord-stromal tumors, germ cell tumors and mixed tumors. The diagnosis, management and treatment options for different types of benign ovarian tumors are provided.
This document discusses benign and malignant breast tumors. Benign tumors include fibroadenoma, intraductal papilloma, and phyllodes tumor. Malignant tumors include in situ carcinomas, invasive ductal carcinoma (the most common), invasive lobular carcinoma, and Paget's disease. Key microscopic features are described, such as the characteristic "Indian file" pattern of invasive lobular carcinoma and large tumor cells within epidermal clefts in Paget's disease.
Uterine leiomyomas, or fibroids, are benign smooth muscle tumors that arise from the uterus. They are very common, affecting approximately 25% of women. Symptoms vary depending on the size and location of the fibroids but can include heavy menstrual bleeding, pelvic pain and pressure, and pregnancy complications. Treatment options include observation for small asymptomatic fibroids, medical management to control symptoms, or various surgical procedures like myomectomy or hysterectomy to remove fibroids.
Presentation1.pptx, radilogical imaging of ovarian lesions.Abdellah Nazeer
Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that is a common complication of sexually transmitted diseases. It can cause long-term issues like chronic pelvic pain, infertility, and ectopic pregnancy due to scarring and adhesions. PID includes conditions like endometritis, salpingitis, and tubo-ovarian abscess. Prompt diagnosis and treatment are important to prevent life-threatening complications due to the varied presentation and sometimes difficultly in detection of PID. Radiological imaging can help identify signs of PID and related conditions like tubo-ovarian abscesses.
Leiomyoma, commonly known as uterine fibroids, are benign smooth muscle tumors of the uterus that are the most common tumors of the female pelvis. They occur most frequently in women during their childbearing years. While the exact causes are unknown, risk factors include high estrogen levels. Leiomyomas can be classified based on their location within the uterus as submucosal, subserosal, or intramural. Magnetic resonance imaging is the most accurate imaging technique for detecting and classifying leiomyomas. Treatment options depend on factors such as a patient's age, parity, symptoms, and the size and location of the fibroids and include conservative approaches, medications, uterine artery embolization,
Adenomyosis is a benign condition where endometrial tissue grows into the myometrium. It causes the uterus to enlarge asymmetrically, especially on the posterior wall. Women with adenomyosis typically experience heavy menstrual bleeding and painful periods that can occur throughout the month. Ultrasound and MRI can detect adenomyosis by showing cysts in the thickened myometrium and an indistinct endomyometrial junction. Treatment depends on a woman's age and fertility desires, ranging from medication like NSAIDs and oral contraceptives to hysterectomy for older, parous women.
The document discusses the ultrasound and MRI appearance of the normal endometrium and various endometrial pathologies including polyps, hyperplasia, and carcinoma. It describes how the endometrium changes in appearance throughout the menstrual cycle in pre- and postmenopausal women. Endometrial polyps appear as focal masses or thickening on ultrasound and low signal masses on MRI. Hyperplasia is suggested by endometrial thickness over 10mm. Endometrial carcinoma demonstrates irregular thickening or an intracaity mass and can invade the myometrium or cervix in advanced stages. The 2009 FIGO staging system for endometrial cancer is outlined. MRI is useful for staging by evaluating myometrial
1) STI's are common among adolescents in the United States, with about 24% of adolescent females having evidence of at least one of the main STI's. Left untreated, STI's can cause infertility and other serious health issues.
2) Common STI's include chlamydia, gonorrhea, trichomoniasis, HPV, HSV-2, and syphilis. Symptoms and signs vary depending on the specific infection, but may include abnormal discharge, ulcers, rashes, or pelvic pain. Many infections can also be asymptomatic.
3) Screening and treatment guidelines exist for various STI's. Regular screening is recommended for sexually active adolescents and young
Syphilis and gonorrhea are both sexually transmitted diseases but they differ in their causes, symptoms, and progression. Syphilis is caused by bacteria Treponema pallidum and if left untreated can spread throughout the body, while gonorrhea is caused by Neisseria gonorrhoeae bacteria and often shows symptoms within 2-3 weeks. Syphilis progresses through distinct stages over a long period of time and can cause sores, rashes, and damage to internal organs if not treated. Gonorrhea typically only causes discharge and painful urination when symptoms are present. While both diseases are transmitted sexually, syphilis can also spread through skin-to-skin contact with sores.
This document discusses the history and uses of ultrasound in gynecology. It was first introduced in 1950 by Ian Donald from Glasgow, UK. Ultrasound is commonly used due to its safety, acceptance, and low cost. Higher frequencies provide better resolution but lower tissue penetration. Ultrasound is used for infertility issues, diagnosing ovulation and ectopic pregnancy, IVF procedures, and evaluating ovarian and uterine masses, cancers, and other gynecological diseases and abnormalities. Transabdominal and transvaginal ultrasound are the main types used. The document provides details on performing transvaginal ultrasounds and evaluating various reproductive organs and structures.
This document summarizes information about benign lesions of the uterus, including endometrial polyps, adenomyosis, and leiomyoma. It discusses the definition, risk factors, clinical features, investigation, and management of each condition. Endometrial polyps are localized outgrowths of the endometrium that can be pedunculated or sessile. Adenomyosis involves the presence of endometrial tissue in the myometrium. Leiomyoma (fibroids) are benign smooth muscle tumors in the uterus. Surgical and medical management options are provided depending on the severity and symptoms of each benign uterine condition.
This document discusses proliferative lesions of the endometrium including endometrial polyps, hyperplasia, and carcinomas. It provides details on the morphology, pathogenesis, risk factors, classification and clinical presentation of each condition. Endometrial polyps are benign overgrowths that can cause bleeding. Hyperplasia is an exaggerated response to estrogen and is classified based on architectural and cytological features. Endometrial carcinoma is the most common cancer of the female genital tract and arises through estrogen exposure or endometrial atrophy. Uterine fibroids are also discussed.
DISEASES OF THE FEMALE REPRODUCTIVE SYSTEMدكتور مريض
The document discusses diseases of the female reproductive system. It provides an overview of the major organs including the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. It then summarizes common diseases that affect each part, such as inflammatory lesions, infections, tumors, and abnormalities in menstruation or bleeding. The diseases discussed include conditions like herpes, syphilis, candidiasis, and various cancers. The document aims to introduce pathology found in the female genital tract.
The müllerian ducts normally fuse during gestation to form the fallopian tubes, uterus, cervix, and upper vagina. Müllerian duct anomalies arise from failed development, fusion, or resorption and cause infertility, miscarriages, or other reproductive issues. They are classified by the American Fertility Society and diagnosed using imaging like ultrasound or MRI. Key indicators include the shape of the uterine fundus and distance between cornua. Precise diagnosis guides treatment and informs prognosis.
Congenital anomalies of female genital tract.pptxaniyakhan948
This document provides an overview of congenital anomalies of the female genital tract. It discusses the embryology and development of the müllerian duct system. Common müllerian duct anomalies include agenesis, errors in vertical or lateral fusion, and anomalies of the urogenital sinus and external genitalia. Specific anomalies covered in detail include Mayer-Rokitansky-Küster-Hauser syndrome, unicornuate uterus, septate uterus, bicornuate uterus, and uterus didelphys. Diagnostic methods like ultrasound, MRI, hysterosalpingography, and laparoscopy are discussed. Prognosis varies between anomalies but septate and unicornuate uteri are associated with higher risks
Uterine malformations occur due to abnormal development of the Mullerian ducts during embryogenesis. Common types include septate uterus (35%), bicornuate uterus (26%), and arcuate uterus (18%). Uterine malformations can lead to infertility, dysmenorrhea, recurrent miscarriage, preterm birth, and obstructed labor due to the abnormal uterine anatomy. Diagnosis involves hysteroscopy, ultrasound, or MRI to visualize the internal and external uterine architecture. Surgical correction through hysteroscopic or abdominal metroplasty may be recommended for otherwise unexplained fertility or pregnancy complications.
Congenital malformations of the female genital tract can result from disturbances during embryonic development. There are many variations in anatomy and combinations of malformations. The document then describes the normal anatomy of the internal and external female genital organs and their development. It discusses the seven main classes of Müllerian duct anomalies, including hypoplasia, unicornuate uterus, bicornuate uterus, septate uterus, and those related to diethylstilbestrol exposure. Complications of Müllerian duct anomalies can include infertility, miscarriage, preterm birth, and abnormal fetal positioning.
The document provides an overview of the normal radiological anatomy of the female pelvic organs including the uterus, endometrium, myometrium, cervix, vagina, ovaries and their appearance on ultrasound and MRI. It then discusses common uterine abnormalities such as congenital uterine anomalies, fibroids, adenomyosis and their imaging features. In adenomyosis, endometrial glands are present within the myometrium which can appear heterogeneous on ultrasound and cause diffuse or focal thickening of the junctional zone on MRI. Uterine fibroids appear as well-defined hypoechoic masses on ultrasound and may cause various signal changes on MRI depending on factors like degeneration. Congenital anomalies result from
New microsoft office power point presentationRiyadhWaheed
This document discusses the role of 3D ultrasound in evaluating uterine diseases and anomalies. It begins by reviewing female reproductive tract embryology. It then describes the American Fertility Society's 7-class system for classifying Müllerian duct anomalies, including uterine agenesis, unicornuate uterus, bicornuate uterus, septate uterus, and DES exposure anomalies. It discusses how 3D ultrasound and MRI can be used to distinguish between septate and bicornuate anomalies. The document also discusses how 3D ultrasound can be used to measure endometrial volume and vascularity, which are important indicators of endometrial receptivity and pregnancy potential.
Uterine malformations can result from failures in agenesis, fusion, or resorption of the müllerian ducts during development. This document discusses several types of uterine anomalies:
1. A septate uterus is the most common anomaly and results from a failure of resorption, leaving a fibrous or muscular septum dividing the uterus. It can increase risks of pregnancy loss and infertility.
2. A bicornuate uterus is partially divided with a fundal cleft. It may be associated with cervical incompetence and early pregnancy loss.
3. A unicornuate uterus has failure of one müllerian duct to develop, resulting in a single-horned uterus that
Presentation1.pptx, ultrasound examination of the uterus and ovaries.Abdellah Nazeer
This document discusses ultrasound examination of the uterus and ovaries. It provides information on normal ultrasound anatomy and techniques for imaging the uterus longitudinally, transversely, and transvaginally. Common pathologies that can be identified include fibroids, polyps, cysts, cancers, and other masses. The roles of ultrasound include examining the pelvic organs, classifying masses, and guiding procedures. Indications for ultrasound and common ultrasound findings are summarized.
Congenital malformations of the female genital tract can occur due to abnormalities during embryonic development. Uterine malformations in particular result from abnormal development of the Mullerian ducts. The most common types are caused by incomplete fusion of the ducts during embryogenesis. Uterine anomalies are often associated with vaginal maldevelopment and may cause issues like infertility, miscarriage, or obstructed labor. Diagnosis involves imaging tests like ultrasound, MRI, or hysteroscopy. Treatment depends on the type of abnormality but may involve surgical procedures to enable pregnancy or reduce risks.
ULTRASOUND EXAMINATION OF Uterine and ovarian pathology by DR ABHIJIT R SINGHDrABHIJITRSINGH
Ultrasound is used to examine the uterus, ovaries, cervix and vagina to identify and characterize masses and pathologies. Common uterine pathologies seen on ultrasound include fibroids, which appear as well-defined hypoechoic masses that can be intramural, subserosal or submucosal. Endometrial polyps and cancer are also identified. Vaginal cysts such as Nabothian and Bartholin gland cysts appear as well-defined anechoic structures. Cervical pathologies include nabothian cysts, polyps and cancer, with cancer appearing heterogeneous and potentially showing increased vascularity on Doppler.
1. The müllerian ducts normally develop into the fallopian tubes, uterus, cervix, and upper two-thirds of the vagina. Failures or abnormalities during development can result in müllerian duct anomalies.
2. Development occurs through three phases - organogenesis, fusion, and septal resorption. Failures in fusion can lead to bicornuate or didelphys uterus, while failed septal resorption causes septate uterus.
3. Müllerian duct anomalies have a variety of presentations including infertility, miscarriage, and obstructed reproductive systems. Diagnosis is made through ultrasound, hysterosalpingography, or laparoscopy.
Developmental anomalies of the female genital tract can occur during embryogenesis from failed fusion of the müllerian ducts. Common anomalies include septate or bicornuate uteri from incomplete midline fusion, as well as uterine didelphys from unilateral duct maturation. Defective vaginal canalization can result in transverse vaginal septa or complete vaginal agenesis. Acquired vaginal abnormalities are rare but may occur from trauma or infection leading to scarring. Pregnancy outcomes can be complicated by structural anomalies including miscarriage, preterm delivery, and abnormal fetal lie. In some cases, surgical correction of the anomaly may be recommended.
Uterine malformation Define, Types,Diagnosis Test,Treatment in word File Use ...sonal patel
This document discusses uterine malformations, which result from abnormal development of the Müllerian duct during embryogenesis. It describes the different classifications of uterine malformations according to the American Fertility Society. The most common type is a septate uterus, which occurs when the intervening uterovaginal septum fails to completely resorb after the Müllerian ducts fuse. Surgical resection of a uterine septum can help decrease miscarriage rates for women with this anomaly. The document also discusses the normal development of the female reproductive system from the Müllerian ducts and how failures during this process can lead to various uterine malformations.
1) Mullerian duct anomalies are congenital abnormalities that occur due to abnormal development of the fallopian tubes or uterus during embryonic development.
2) They are classified into seven main classes depending on the extent of fusion failure of the Mullerian ducts during development.
3) Diagnosis is often made initially with ultrasound or MRI, with MRI considered the gold standard for classification. Treatment depends on the specific class of anomaly but may include surgical resection or metroplasty.
Mullerian duct anomalies occur due to abnormal development of the paired mullerian ducts in females during embryological development. The three main phases of mullerian duct development are organogenesis, fusion, and septal resorption. When one or more of these phases are disrupted, it can lead to mullerian duct anomalies such as a bicornuate or septate uterus. Mullerian duct anomalies are diagnosed using imaging modalities like ultrasound, MRI, and hysterosalpingography which allow visualization of the uterine cavity and identification of the specific anomaly present. The most common anomalies include septate uterus, bicornuate uterus, and arcuate uterus.
3D and 4D ultrasound provide several advantages over traditional 2D ultrasound for assessing female pelvic anatomy and pathology. Multiplanar views allow for more accurate diagnosis of uterine anomalies by visualizing the coronal and true midline planes. Intracavitary lesions can be precisely localized. Ovarian volumes and antral follicle counts are more accurately determined. Endometrial receptivity markers like vascular indices are measurable. Doppler of uterine arteries provides additional information on receptivity. Overall, 3D/4D ultrasound improves evaluation of female pelvic structures and fertility-related conditions.
Congenital abnormalities of reproductive systemVahitha Vahitha
The document discusses congenital abnormalities of the female reproductive system. It begins by describing the normal anatomy and functions of the uterus, ovaries, fallopian tubes, vagina, and cervix. It then discusses various types of developmental anomalies that can occur, including defects in fusion of the müllerian ducts that can result in septate or bicornuate uteri. Other abnormalities include cervical duplication, vaginal atresia or septa, and unicornuate or didelphys uteri. Many anomalies are associated with complications in pregnancy like miscarriage or preterm delivery. Surgical treatments like metroplasty or cerclage may help in some cases.
The document discusses contracted pelvis, including definitions, types, causes, effects on pregnancy and labor, and management. Anatomically, a contracted pelvis has one or more essential diameters shortened by at least 0.5 cm. Obstetrically, it alters normal labor mechanism. Contracted pelvises can be classified as flat, rachitic, osteomalacic, or asymmetrical. Causes include nutritional deficiencies. Effects include slower labor, operative deliveries, and maternal and fetal risks. Management depends on degree of contraction and may include induction, cesarean section, or trial labor.
Similar to Benign pelvic diseases in females 2 (20)
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
3. MULLERAIAN DUCT ANOMALIES
• The müllerian ducts are paired embryologic structures that
undergo fusion and resorption in utero to give rise to the
uterus, fallopian tubes, cervix, and upper two-thirds of the
vagina.
Normal process of
• ductal development (6wks),
• ductal fusion (6-9wks),and
• septal reabsorption (9-12wks).
Interruption at stage of
• ductal development - hypoplasia or aplasia of uterus.
• ductal fusion -bicornuate uterus and uterine didelphis.
• septal reabsoption -arcuate and septate uterus.
• It is often associated with primary amenorrhea, infertility,
obstetric complications, and endometriosis.
• MDAs are commonly associated with renal and other
anomalies
4. ASSOCIATED ANOMALIES
MDAs are also commonly associated with
Renal anomalies-30%–50%
including renal agenesis (most commonly unilateral
agenesis), ectopia, hypoplasia, fusion, malrotation,
and duplication .
• Other
vertebral bodies -(29%)
wedged or fused vertebral bodies and spina
bifida(22%–23%),
cardiac anomalies (14.5%), and
syndromes such as Klippel-Feil syndrome (7%) .
6. • The Müllerian duct anomaly classification is a seven point system that can
be used to describe a number of embryonic Müllerian duct anomalies:
• class I: uterine agenesis/uterine hypoplasia
– a: vaginal (uterus: normal/ variety of abnormal forms)
– b: cervical
– c: fundal
– d: tubal
– e: combined
• class II: unicornuate uterus/unicornis unicollis, ~6-25%
– a: communicating contralateral rudimentary horn contains endometrium
– b: non-communicating contralateral rudimentary horn contains endometrium
– c: contralateral horn has no endometrial cavity
– d: no horn
• class III: uterus didelphys, ~5-11%
• class IV: bicornuate uterus: next commonest type, ~10-39%
– a: complete division, all the way down to internal the os
– b: partial division, not extending to the os
• class V: septate uterus: commonest anomaly, ~34-55%
– a: complete division, all the way down to internal the os
– b: incomplete division
• class VI: arcuate uterus, ~7%
• class VII: in utero Diethylstilbestrol (DES) exposure: T shaped uterus
7. Classification of MDAs on the basis of the American Society for Reproductive Medicine system. DES = diethylstilbestrol. (Courtesy of Joanna Culley,
8. Mayer-Rokitansky-Küster-Hauser syndrome. (a) Sagittal T2-weighted MR image shows complete
absence of the cervix and uterus with an abnormally truncated vagina ending in a blind pouch
(arrowhead) between the rectum (r) and urinary bladder
(b) Axial T2-weighted image shows the presence of normal ovaries (*).
9. UNICORNUATE UTERUS
Results from normal development of one mullerian duct and near
complete to complete arrested development of the contralateral
duct.
This anomaly has four subtypes:
(a) no rudimentary horn
(b) rudimentary horn with no uterine cavity
(c) rudimentary horn with a communicating cavity to the normal
side, and
(d) rudimentary horn with a noncommunicating cavity.
40% cases are associated with renal anomalies
ipsilateral to the rudimentary horn, with renal agenesis
being the most common (67% of cases)
10. Unicornuate uterus with no rudimentary horn.
HSG image shows a small, oblong uterine cavity (*) deviated to the right
of midline with a single fallopian tube (arrowhead).
11. Unicornuate uterus with no rudimentary horn. .
axial T2-weighted MR image shows a single uterine horn (*) and cervix (arrowhead).
Coronal T2-weighted MR image shows absence of soft tissue adjacent to the right
unicornuate cervix (arrowhead), a finding indicating absence of a rudimentary horn.
12. Unicornuate uterus with an obstructed noncommunicating rudimentary
horn. Axial T2- weighted MR images show a normal-appearing left
unicornuate uterus (arrow in a) and an obstructed noncommunicating
right rudimentary horn with layering debris (* in b).
13. UTERINE DIDELPHIS
complete failure of müllerian duct fusion.
Duplication of the uterine horns, cervix, and proximal
vagina .
Usually asymptomatic
Hematometrocolpos may occur if there is transverse
hemivaginal septum resulting in ipsilateral
obstruction
Patients with hemivaginal obstruction present with
dysmenorrhea secondary to endometriosis,
infections, and pelvic adhesions attributed to
retrograde menstrual flow from the obstructed side .
It is commonly associated with ipsilateral renal
agenesis
14. HSG demonstrates two separate, oblong endometrial
cavities with contrast opacification of fallopian tubes
• USG-widely divergent uterine horns with separate,
non communicating endometrial cavities.
There is two cervices and duplicated upper vaginas
• MR-Endometrial-to-myometrial ratio and zonal
anatomy are normal.
Duplication of the proximal vagina may be visualized at
MR imaging, and this may be further improved by
instillation of viscous liquid, such as ultrasound gel, into
the vagina before imaging.
15. Transverse transabdominal US image shows a uterus didelphys, with two uterine
horns (u) separated by echogenic fat (*). There is a viable embryo (arrow) in the left
uterine horn.
16. Uterus didelphys with an obstructed hemivagina.
(a) Coronal T2W MR image shows widely separated horns of a uterus (white arrows).
Two hemivaginas (arrowheads).
absent left kidney (black arrow) with bowel in the renal fossa, which is ipsilateral to the
obstructed hemivagina.
(b) Axial T2-weighted image shows the two hemivaginas (arrowheads); the obstructed,
dilated left hemivagina contains heterogeneous debris (*).
17. • BICORNUATE UTERUS-
incomplete or partial fusion of the müllerian ducts .
presence of a cleft (>1 cm in depth at MR imaging)
in the external contour of the uterine fundus.
The duplicated endometrial cavity may be associated
with cervix duplication (bicornuate bicollis) or be
without cervix duplication (bicornuate unicollis).
18. • HSG- Opacification of two symmetric fusiform uterine
cavities (horns) and fallopian tubes. Historically, an
intercornual angle of greater than 105° was used for
diagnosis.
• US-divergent uterine horns and separation of uterine
cavities may be optimally seen in the secretory phase
of the menstrual cycle due to echogenicity of the
endometrium .
• MR-both uterine horns have normal zonal anatomy.
The appearance of a duplicated cervix (“owl eyes”) is
seen in patients with a bicornuate bicollis uterus, which
can be confidently diagnosed in the absence of vaginal
duplication
19.
20. SEPTATE UTERUS-
Most common form of MDA (55%),
The septum originates from the midline of the
uterine fundus and extend caudally.
Result of complete or partial failure of reabsorption
of the uterovaginal septum.
The septum –partial
- complete(extends upto external cervical os
in some cases upto upper vagina.)
Fibrous tissue and myometrium
21. • HSG-HSG cannot be used to evaluate the
external uterine contour and therefore does
not allow reliable differentiation of septate
from bicornuate uterus .
• USG-interruption of the myometrium by a
septum at the fundus . The fibrous component
of the septum is less echogenic relative to
myometrium .
• MR-the uterus is normal in size.The key to
differentiating a septate uterus from a
bicornuate uterus is the external fundal
contour.
22. HSG image of a partial septate uterus shows a thin
linear filling defect (arrow) extending from the uterine
fundus, separating the uterine cavity into two
symmetric cavities
23. USG image of partial septate uterus shows the isoechoic muscular septum and
hypoechoic fibrous septum (*), extends just proximal to the internal cervical os
(arrowhead).The apex of the fundal contour (arrow) is more than 5 mm above a line
drawn between the tubal ostia (white line).
24. Axial T2-weighted MR image of a complete septate uterus shows a normal
external uterine contour (black arrow). The hypointense fibrous septum (white
arrows) originates from the isointense muscular septum and extends into the
cervical os (arrowhead). A hypointense uterine fundal fibroid (f) is also present.
25. • A line drawn between the uterine ostia may
be used to differentiate between a septate
and bicornuate uterus. In a septate uterus, the
apex of the external fundal contour is more
than 5 mm above the interostial line. By
comparison, in a bicornuate or didelphys
uterus, the apex of the external fundal
contour is below or less than 5 mm above the
interostial line .
26. Difference between septate and bicornuate
uterus
• Features septate uterus bicornuate uterus
1.Depth of fundal cleft ≤ 1cm > 1cm
2.Fundal contour convex or flat deep fundal
concavity
3.Intercornual angle < 75° >105°
4.Intercornual distance < 4 cm > 4 cm
5.Intercornual Fibrous or myometrial myometrial
tissue
27.
28. • ARCUATE UTERUS-
Near reabsorption of the uterovaginal septum.
Only mild indentation of the external fundal
contour .
This is mild form of MDA and is typically
associated with normal-term gestation.
29. • HSG-A single uterine cavity with a broad
saddle-shaped indentation at the uterine
fundus .
• USG –shows a broad, smooth inward contour
deformity of the uterine fundus .
There is a normal external contour.
MR -Normal-sized uterus and the normal
convex external uterine fundal contour. There is
a broad-based, smooth prominence of soft
tissue at the fundus with indentation of the
endometrial cavity .
30. HSG image shows a broad-based uterine fundal
filling defect (black arrowhead). White
arrowheads = patent fallopian tubes
31. Coronal 3D US image shows the broad-based fundal myometrial
prominence (*) and a convex external uterine contour
(arrowheads).
32. Axial gadolium-enhanced T1-weighted fat-saturated MR
image shows the convex external uterine contour (arrow) and
the broad-based prominent fundal myometrium (*).
33. • DES Uterus –
classic T-shaped configuration of uterus in
31% of exposed women .
T-shaped appearance is secondary to the
shortened upper uterine segment .
The fallopian tubes are often truncated and
have an irregular appearance .
constriction bands at the midfundal segment
may be present, which leads to narrowing of
the proximal fallopian tube
34. HSG image shows the classic T-shaped
uterine cavity due to DES exposure
35. UTERINE LEIOMYOMA
• Found in 20-30% of women in reproductive years.
Well circumscribed and surrounded by pseudocapsule.
INTRAMURAL
most common
mostly asymptomatic
SUMUCOSAL
mostly symptomatic
may protude into cervical canal k/a cervical fibroid.
SUBSEROSAL
mostly projects into endometrial canal.
may undergo torsion and thereafter infarction.
Lateral growth of subserosal leiomyoma may extend between two
layers of broad ligament k/a intra-ligamentous leiomyoma.
Large tumours may develop hyaline,cystic and myxomatous
degeneration.
In postmenopausal women may undergo calcification.
36. Common symptoms
bleeding,
pain, pressure over adjacent organs
infertility.
USG
• hypo to hyper,
• homogenous to heterogenous,
• with or without acoustic shadowing depending on contents,
• but most common appearance is well marginated round or oval
mass and shows peripheral supply.
MR
• most sensitive imaging for leiomyoma , can identify lesions even
smaller than 3mm.
• most common appearance is –hypo on T2WI,iso to myometrium on
T1WI,presence of calcification shows signal void on both T1 and
T2WI.
• MR facilitates differentiation of pedunculated leiomyoma from an
adnexal mass on basis of typical signal intensity and morphology.
37. .
POST CONTRAST MR
less enhancing than both endometrium and myometrium
Fibroids with myxomamatous degeneration shows
heterogenous contrast enhancement.
helpful in localising uterine artery supplying the fibroids
and further in management as uterine artery embolisation.
Exophytic leiomyoma shows bridging vessel sign which
refers to presence of flow voids on both T1 and T2 from
branches of uterine artery that are localised between mass
and uterus.
Malignant degeneration is rare(0.1-0.6%) and should be
suspected if a leiomyoma enlarges suddenly , or if indistinct
border ,irregullar contour along with contrast
enhancement noted on MR imaging.
38. A- shows well defined intramural fibroid .B- shows submucosal
fibroid with displacement of endometrium posteriorly.
40. Prolapsed pedunculated leiomyoma manifesting as a vaginal mass
Sagittal T2W image show a mass of low to intermediate signal intensity (arrow) within
a distended vaginal canal , which is continuous superiorly with the endometrial canal .
41. sagital T2WI shows
hemmorrhagic degeneration in
subserosal leiomyoma
Axial T1-weighted SE MR image
obtained 4 months later shows
maturation of the hemorrhage
with high signal intensity confined
to the rim
44. ADENOMYOSIS
It is uterine endometriosis in which there is ectopic
endometrial glands and stroma with surrouding smooth
muscle hyperplasia within the myometrium.
TYPES-Focal(also k/a adenomyomas)
diffuse
May occur along with fibroids.
45. USG
TVS is most sensitive.
diffuse form-bulky uterus with
1)poorly defined hypoechoic myometrium.
2)heterogenous myometrium.
3)asymmetrically thickened myometrial wall
4)shaggy endometrium with poor definition
between endometrium and myometrium.
5)scattered small (<5mm)myometrial cysts.
Focal form-shows indistinct margin and presence of
hypoechoic lacunae in hyperechoic myometrium
with several cysts.
46. PELVIC MRI:
modality of choice to diagnose and characterize
adenomyosis,
T2W images (sagittal and axial) are most useful.
sensitivity of 78-88% and a specificity of 67-93% .
thickening of the junctional zone of the uterus >12 mm,
either diffusely or focally (normal junctional zone measures
no more than 5 mm)
• small high T2 signal regions representing small regions of
cystic change the region may also have a striated
appearance.
• T1: Foci of high T1 signal are often seen, indicating
menstrual hemorrhage into the ectopic endometrial tissues.
• T1 C+ (Gd): contrast enhanced MR evaluation is usually not
indicated in adenomyosis, however if performed, it shows
enhancement of the ectopic endometrial glands.
47. NORMAL MR ANATOMY OF UTERUS
T1WI
The entire uterus is isointense to muscle and different
anatomic zones cannot be identified
T2WI
• The central high-signal intensity endometrium and
secretions
• The middle low-signal intensity junctional
zone(innermost layer of myometrium ) measures 2 to 8
mm.
• The appearance of the junctional zone changes with
sustained myometrial contractions or uterine
peristalsis are important to distinguish from
leiomyomas or adenomyosis.
• The outer intermediate-signal intensity of the
myometrium.
48. Uterus is evaluated between isthmus and end of uterine cavity (white lines).
Junctional zone (short arrows) should be measured from several sites on
anterior and posterior walls. Junctional zone measure can be compared with
entire thickness of myometrium (long arrows) evaluated at same site.
49.
50.
51. MRI (sagittal T2WI) shows adenomyosis with abnormal increase in thickness of
junctional zone (12 mm) and abnormal high T2 SI of the myometrium represents
abnormal stromal glands inside the myometrium. B: MRI (coronal T2WI) shows
the same finding as well as bilateral ovarian simple cysts.
52. Axial and sagittal T1, T2 and postcontrast
images reveal bulky uterus with thickening and
heterogeneity of junctional zone (JZ), poorly
defined endomyometrial
junction, multiple small T2 hyperintense foci in
JZ showing heterogeneous contrast
enhancement – Diffuse
adenomyosis
53. features adenomyosis Leiomyoma
Margins Poorly defined Well circumscribed
Centre Junctional zone Any layer of uterus,
originates in
myometrium
Appearance Focal or diffuse focal
T2 signal intensity Small hyperintense
foci
Hypointense unless
degeneration present
Thickened junctional
zone
Yes >12mm No
Mass effect on
endometrium
Minimal or none + if intracavitary or
submucosal
54. ENDOMETRIAL POLYP
• are localized hyperplastic overgrowth of endometrial
glands and stroma which are covered by endometrium.
• may be sessile or pedunculated and usually attached to
the uterine fundus.
USG-thickened endometrium, a focal echogenic area in the
endometrium or occasionally an endocavitary mass
surrounded by fluid. With Color Doppler, a feeding artery
may be seen in the pedicle of the polyp.
SONOHYSTEROGRAPHY- is an ideal technique for diagnosis .
This is because a polyp seen as a round echogenic mass
within the endometrial cavity is much more easily
identified when there is fluid in the endometrial cavity
outlining the mass
55. MR
T1WI- isointense to endometrium.
T2WI-intermediate signal intensity.
Contrast enhanced MRI- improve the sensitivity
of detection
polyps generally enhance less than the
edometrium but more than myometrium .
56.
57. SUBMUCOSAL FIBROID ENDOMETRIAL POLYP
Broader base
More irregular contour on
sonohysterography.
Sessile or pedunculated, almost well
defined echogenic mass on
sonohysterography
Normal layer of endometrium is seen
overlying submucosal fibroid.
Outlined by endometrium.
MR-generally of lower intensity than
polyp on T2WI.
Isointense to myometrium on T1WI
Intermediate –T2
Iso to endometrium on T1.
CEMR-non enhancing ,lower signal
intensity than both endometrium or
myometrium.
Polyps enhances less than the surrounding
endometrium but more than myometrium.
58.
59. • ENDOMETRIAL HYPERPLASIA-
• On ultrasonography, a bilayer endometrial width
>5 mm is regarded as abnormal in symptomatic post
menopausal women.
>8mm In asymptomatic postmenopausal women on
HRT, cut off values range from < 5 to > 8 mm while in
>8mm in premenopausal women in the proliferative
phase and
> 16 mm in the secretory phase.
60. TVS reveals diffuse thickened echogenic
endometrium with small cysts within–
Endometrial hyperplasia
61.
62.
63.
64.
65. POLYCYSTIC OVARIAN SYNDROME
According to Rotterdam crieteria
1) one or both ovaries demonstrate 12 or more follicles
measuring 2–9 mm in diameter ,or
2) The ovarian volume exceeds 10 cc.
Only one ovary meeting either of these criteria is sufficient
to establish the presence of polycystic ovaries
Stromal echogenicity on USG.
• Any follicle >10 mm or corpus luteum
should prompt repeat US during the next menstrual cycle)
• Ovarian volume, calculated with the simplified formula
for an ellipsoid (0.5 × length × width × thickness)
66.
67. characteristic T2-weighted MR imaging appearance of a
polycystic ovary is abundant hypointense central stroma with
small peripheral T2-hyperintense cysts
68. CYSTADENOMAS
SEROUS CYSTADENOMA-
Counts for 25% of benign
epithelial neoplasm
Thin walled ,unilocular of
size upto 10cm.
Contain clear fluid ,little or
no septations.
Papillary projections are
generally absent.
Bilateral upto 23% of cases.
MUCINOUS CYSTADENOMA-
45%
Thick walled,multilocular of
size 15- 30 cm.
Contain thick mucinous
content,
septas and papillary
projections are present but
les than 3mm thick in
benign form
Less commonly
bilateral(upto 5%)
Chances of malignancy is
more.
71. DERMOID CYST OR MATURE CYSTIC TERATOMA-
USG-
Focal or diffuse hyperechoic component with distal
acoustic shadowing represent fat.-k/a dermoid plug
Fluid fluid level or layering of fat k/a floating fat sign.
Hyperechoic lines or dots k/a dermoid mesh represent
different component within like hair or calcification.
No internal flow on colour Doppler.
When a dermoid produces ill-defined acoustic shadowing
that obscures the posterior wall of the lesion, it is termed
as“Tip-of-the-iceberg-sign”. This is produced by a mixture
of matted hair and sebumwhich is highly echogenic
because of multiple tissue interfaces.
72. CT
Detection of fat (–130 to -90 HU),hair ,teeth and fat-
fluid level.
MRI
Fat is identified when the signal intensity of the mass
(or part of it) is isointense to subcutaneous fat on both
T1 and T2 weighted sequences and
internal or external chemical shift artefact indicating
fat water interface is present.
On fat saturation sequence, suppression of signal that
was of high signal intensity on T1 weighted sequence;
confirms the presence of fat within the mass
Intramural solid enhancing component on cross sectional
images suggest malignancy.
73. Cystic ovarian mass with an echogenic mural
nodule in the periphery representing “dermoid
plug”-cystic teratoma
74. Ovarian mature cystic teratoma-
shows cystic ovarian mass of fat attenuation,
with fat fluid level, central hair ball and areas of calcification
75. A) B/L complex masses with bright signal of fat anteriorly
on T1W image. (B) T1W fat-suppressed image showing
suppression of fat signal with chemical shift artifact at fat fluid
interface
76. Endometriosis
is defined as the presence of endometrial
epithelium and stroma in an ectopic site outside
the uterine cavity . Endometriosis occurs in 10%
of the female population and almost, exclusively,
in women of reproductive age . The most
common symptoms are dysmenorrhea,
dyspareunia, pelvic pain, and infertility although
endometriosis may be asymptomatic .
77. Superficial endometriosis ( Sampson's syndrome )
superficial plaques are scattered across the
peritoneum, ovaries and uterine ligaments.
minor symptoms and usually also less structural
changes in the pelvis.
At laparoscopy, implants are be seen as superficial
powder-burn or gunshot lesions.
Deep pelvic endometriosis- (Cullen's syndrome)
There is subperitoneal infiltration of endometrial
deposits.Severe symtoms and more invasive.
MRI is of use for the diagnosis of deep infiltrating
endometriotic lesions and for the assessment of disease
extension. Preoperative mapping of disease extension is
important to decide whether surgical intervention is
indicated, and if so, for planning complete surgical
excision
79. Endometriomas - also known as chocolate cysts
Develop when superficial endometriotic lesions on the surface
of the ovary invaginate.
Blood produced by such an implant during each menstrual
cycle cannot escape and will accumulate within the ovary,
forming a cyst known as an endometrioma.
present as complex cystic masses, often thick-walled with a
homogeneous content.
On transvaginal ultrasound, endometriomas may be seen as
thick-walled cysts with low level echoes.
SYMPTOMS -
• Pelvic pain(65%).
• . Dysmenorrhea, especially suggestive of endometriosis the pain if it occurs
after years of pain free menstruation.
• . Deep dyspareunia.
• . Chronic pelvic pain.
• . Ovulation pain with menstrual irregularity.
• . Other types of pain- Sciatica.
- Infertility(35%).
80. TVS showing a unilocular ovarian cyst with low level internal echoes –
characteristic of
Endometrioma.
82. • HYDROSALPINX –Hydrosalpinx occurs when an inflammatory
process produces adhesions of the fimbriated end of the
fallopian tube, trapping the intraluminal secretions and
dilatation of the ampullary and infundibular portions of the
tube.
• It may occur either in isolation or as a component of a
complex pathologic process (eg, pelvic inflammatory disease,
endometriosis, fallopian tube tumor,peritubal obstruction,
due to previous surgery or tubal pregnancy)
Diagram shows the anatomy
of a normal fallopian tube. There
are four segments, from the medial
aspect
to the lateral aspect: the intramural
portion, the isthmus, the ampulla, and
the infundibulum at the fimbriated end.
83. USG
Tubular, elongated extra-ovarian structure with folded
configuration (incomplete septation )
Three appearances of tubal wall structure
“COGWHEEL “ SIGN- which is anechoic cogwheel shaped
structure visible in the cross section of the tube with thick walls,
“BEADS ON A STRING” SIGN, which are hyperechoic mural
nodules of 2 to 3 mm in size and seen on the cross-section of the
fluid filled distended tube.
INCOMPLETE SEPTA -which are hyperechoic septa that originate
as a triangular protrusion from one of the walls, but do not reach
the opposite wall
84. (A) TVS reveals tubular elongated extraovarian structure. (B) Incomplete septation and
absence of vascularity on CDS - Hydrosalpinx
85. A and B: T2W axial and sagittal images showing a hyperintense tubular structure
with folded configuration in the right adnexa – Hydrosalpinx
86. • In case of complex masses causing hydrosalpinx MR is
more sensitive modalities.
• MR demonstrates incomplete septations and a separate
normal ovary.
• MR can also help in finding the etiology of hydrosalpinx. If
hydrosalpinx is due to endometriosis, signal intensity
characteristics of the tubal fluid are similar to those in
endometriomas (high T1 and low T2 signal intensities). In a
patient with adhesions, signal intensity of the dilated tube
follows that of simple fluid (low T1 and high T2 signal
intensities).
The hydrosalpinx appears as a fluid-filled tubular structure
that arises from the upper lateral margin of the uterine
fundus and is separate from the ipsilateral ovary. A dilated
fallopian tube folds upon itself to form a sausage like C- or S-
shaped cystic mass.
87. Hydrosalpinx in a 38-year-
old woman who
underwent surgical
resection of a
left ovarian cyst 3 years
earlier.
T2-weighted MR images
show a tubular cystic
lesion (solid arrows) in the
left adnexa.
The lesion is separate
from the normal left
ovary (open arrow). The
presence of a
hydrosalpinx with a
peritubal
adhesion was confirmed
at surgery
88. • MR imaging features of tubal pregnancy
include hematosalpinx, enhancement of
the dilated tube wall, presence of a
gestational sac, bloody ascites, and a
heterogeneous adnexal mass.
89. Left tubal pregnancy (at 9 weeks of gestation) in a 44-
year-old woman.
(a, b) Sagittal contrast-enhanced
fat-suppressed T1-weighted MR images show a C-
shaped cystic structure (arrows in b) that contains a
focally enhancing gestational sac (arrow in a) in the left
adnexa. U = uterus.
(c) Coronal contrast-enhanced fat-suppressed T1-
weighted MR image shows a mildly dilated left fallopian
tube (white arrow) with a focally thickened and
enhancing wall(black arrows). At surgery, the presence
of an unruptured tubal pregnancy was confirmed.
B = urinary bladder, U = uterus.
90. TUBO-OVARIAN ABSCESS
Late complication of PID
• Tuberculosis,actinomycosis and
xanthogranulomatous infections are major
causes.
• Bilateral adnexal involvement is the rule.
USG
unilocular or multilocular complex mass
irregular borders and thickened wall.
Multiple internal septations
Fluid in cul de sac
91. CT
Thick wall and shaggy margins
complex adnexal mass with centers of low attenuation.
presence of air confirms the diagnosis.
MR
unilocular or multilocular cystic mass with a thicker wall than
that seen in functional ovarian cyst.
The abscess fluid has variable signal but usually is of very high
signal intensity on T2-weighted image and low signal intensity
on T1-weighted image
The abscess wall and adjacent inflammatory changes as well
as septations enhance intensely with gadolinium.
Infiltration of pelvic fat surrounding the mass may be seen.
92. TVS reveals bilateral multilocular complex adnexal masses with septations and associated free
fluid–
Tubo-ovarian abscesses
96. Actinomycosis
occurs in presence of IUCD.
it is more solid as compared to other bacterial
abscess.
Diffuse infiltration of the uterus, adnexa and pelvic
musculature with obliteration of fascial planes is
the hall mark of the disease.
A linear, solid, well-enhancing lesion extending
directly from the mass into adjacent fascial planes is
a characteristic CT and MR imaging finding.
Small rim-enhancing lesions in the solid part of the
mass are also suggestive of actinomycosis.
Differentiated from malignancy can be done only by
identification of sulphur granules within the
aspirate.
98. When a complex cystic tubo-ovarian abscess
occurs in association with ascites and
lymphadenopathy, it may be difficult to
differentiate the abscess from an ovarian
malignancy. However, ovarian cancer is not
usually associated with tubal dilatation.
Therefore, the detection of a hydrosalpinx
within a complex adnexal mass may aid in the
differential diagnosis
99. OVARIAN TORSION
• acute condition requiring prompt surgical intervention
• caused by partial or complete rotation of the ovarian pedicle
on its long axis.
• It is most commonly associated with an adnexal mass,usually
a dermoid cyst,
• but may also occur spontaneously.
100. ON GRAY-SCALE ULTRASOUND
• Unilateral enlarged ovary (>4cm in maximum
dimension ,vol>20 cc in premenopausal and >10 cc in
postmenopausal women)
• central afollicular stroma and multiple uniform 8–12-
mm peripheral follicles
• free fluid,
• a twisted pedicle
ON COLOUR DOPPLER
• Worlpool sign- is swirling target of vessel in twisted
pedicle.
Torsion first affect venous then arterial flow.
Absence of venous flow
Absent diastolic flow forming a spike waveform pattern
101.
102. 23-year-old woman with enlarged right torsed ovary.
Sagittal fast spin-echo T2-weighted MRI shows 10-cm
ovary (arrow) with mildly T2 hyperintense afollicular
central stroma and peripheral follicles.
103. 18-year-old female with ovarian torsion. T2-weighted, sagittal MR image
showing "whirlpool appearance" of the right adnexa (thick arrow)
suggestive of ovarian torsion. Right ovarian cystic mass is also seen (thin
arrow).
104. ECTOPIC PREGNANCY-
Most common symptoms are-acute abdominal pain
bleeding par vagina
abdominal mass
Positive pregnancy test(b-HCG>2000mIU/mL).
• Risk Factors of Ectopic Pregnancy
Prior ectopic pregnancy
History of pelvic inflammatory disease, gynecologic surgery
Infertility
intrauterine device
History of placenta previa
Use of in vitro fertilization
Congenital uterine anomalies
History of smoking
Endometriosis
105. Ovarian ectopic
3%of cases
Should be differentiated from normal corpus
luteum cyst of pregnancy.
Tubal ectopic
most common location(>95%)
75%–80% - ampulla
10% -isthmus
5% - fimbrial end
2%–4% interstitial and corneal
Others-cervical, abdominal and scar ectopic
106.
107. On USG
Endometrial findings-
Absent G-sac in endometrial cavity or Pseudosac with
absent or poor decidual reaction
Tubal ectopic-we can find a tubal ring with a yolk sac and
embryo or yolk sac only or without any central identifying
features.
a complex adnexal mass separate from the ovary
ovarian ectopic-The presence of a gestational sac,
chorionic villi, or an atypical cyst with a hyperechoic ring
within the ovary, along with the normal fallopian
tubes, is suggestive of an ovarian pregnancy
Colour Doppler
Ring of fire appearance
Low impedance ,high diastolic flow(low RI,high velocity)
111. Scar ectopic pregnancy.
A G-sac in the anterior lower uterine segment in the region of
the cesarean section scar.
112. BENIGN SOLID OVARIAN MASSES
Arise from ovarian stroma also k/a sex cord stromal
tumours.
Fibroma
Thecoma
Fibroadenoma
80% of these tumours produce hormones except
fibroma.
Fibroma is common in postmenopausal women and
are generally asymptomatic.
Ascites seen 50% of patient with fibroma larger than
5cm.
MEIG’S SYNDROME –triad of ovarian fibroma ,ascites
and pleural effusion.
113. USG- hypoechoic mass with marked posterior
attenuation of the sound beam seen separate from
the uterus and a non-visualized ovary.
Due to ascending infection that spreads to involve the endometrium and fallopian tubes.
The ovaries are relatively resistant to infection and are involved only in more severe cases
b/l compex enhancing mass (c)pyosalpinx/(d)thickened uterosacral ligament.
(a) Coronal T2-weighted MR image shows a cystic mass (open arrow) in the left adnexa. A
tortuous elongated cystic structure (solid arrows) is seen along the lateral margin of the lesion, a finding
suggestive of a hydrosalpinx. Diffuse adenomyosis of the uterus (U) also is seen. (b) Sagittal contrast enhanced
fat-suppressed T1-weighted MR image shows the thickened, enhancing wall of the dilated
tube (solid arrows) and ovary (open arrow). At laparoscopy, the left ovary and tube were closely adhered
Contrast-enhanced CT scan shows a round, solid mass (arrows) in the right adnexal region. Multiple small, rim enhancing
lesions (arrowheads) are seen inside the mass
well-enhancing solid lesion (arrows) extending posteriorly from the mass, enhancing perirectal mass
An IUD is noted
Image from a barium study of the rectosigmoid shows segmental
narrowing of the distal sigmoid colon with a serrated border (arrows), an appearance indicative of invasion by the
Ovarian pregnancy have thick and echogenic walls than corpus luteum cyst.
Dilatation of tube is more likely from bleeding into the wall of tube rather than by G-sac.