The document discusses various medical imaging findings related to gynecology, urology, and prenatal diagnosis. Key topics include fluid collections in the endometrial cavity, hydroceles in males and females, and classifications of cleft lip/palate abnormalities. It emphasizes the role of ultrasound in diagnosing these conditions and the importance of understanding anatomy and pathology for proper management.

1.  Dr Arun Gupta
Director imaging
 Dr Rakhee gupta
Dr Vinayak Mittal
 Dr Niharika
Mahajan
 Dr Samkit k Sagma
 Dr Varun
 Dr Ritesh Mahajan
• ENDOMETRIUM
( NORMAL / FLUID DISTENDED /
INDENTED BY FIBROIDS)
• FEMALE HYDROCELE
( CYST IN CANAL OF NUCK)
• PATENT PROCESSUS VAGINALIS
• GRADE FOUR CLEFT LIP / PALATE
• ELASTOGRAM IN TORSION TESTIS
ADVANCED
USG LOUNGE

2. ENDOMETRIAL
CAVITY
A (fairly) normal uterine cavity and endometrial lining are
necessary in order to conceive and maintain a pregnancy. There
are several conditions related to the cavity or the lining that can
cause problems. 3 D RENDERED IMAGES CAN HELP IN
FAIR VISUALIZATION OF CONTOUR AND CONTENTS OF
CAVITY .

4. SUBMUCOSAL
FIBROID
SUBSEROSAL FIBROID SPARING THE
CAVITY

5. FETAL HEAD
DORSUM OF
FETALTORSO
FLUID
IN ENDOMETRIAL CAVITY
Fluid in the endometrial cavity
can result from a number of causes
if excessive and associated with distension.
Pathology
There are essentially three types of fluid:
hydrometra: simple fluid
haematometra haemorrhagic content / clot
pyometra: pus
Premenopausal
normal (i.e. physiological)
cervical stenosis
imperforate hymen
Postmenopausal
Often a concern and some advocate the presence
of echogenic fluid or an accompanying
abnormal endometrial thickness as an indication
for endometrial sampling
• cervical stenosis
• endometrial carcinoma
• endometrial hyperplasia
• endometrial polyp
• cervical polyp
• use of oestrogen replacement therapy
Normal endometrial contour and thickness and
relatively homogenous Fluid with no mid level echoes
s/o BENIGN ETIOLOGY.

6. Spermatic cord hydrocele
(SCH) refers to loculated fluid
collection along the spermatic cord.
It separated from and located above
the testicle and the epididymis.
It results from aberrant closure of the
processus vaginalis.
There are two recognised sub types
ENCYSTED HYDROCELE -
fluid collection does not
communicate with the peritoneum
above or the tunica vaginalis below.
FUNICULAR HYDROCELE -
fluid collection communicates with
the peritoneum at the internal
inguinal ring but does not
communicate with the tunica
vaginalis
PATENT PROCESSUS VAGINALIS

7. PATENT PROCESSUS VAGINALIS
No communication with tunica vaginalis .
There is communication with peritoneum
HENCE FUNICULAR HYDROCELE ( SUBTYPE OF
SPERMATIC CORD HYDROCELE) IS CONSIDERED

8. Hydrocele of the canal
of Nuck is a rare
condition in female
children caused by a
failure of complete
obliteration of the canal
of Nuck . The canal of
Nuck is an abnormal
patent pouch of
peritoneum extending
anterior to the round
ligament of the uterus
into the labia
majora .Incomplete
obliteration of this canal
(patent processus
vaginalis) can result in
either an inguinal
hernia or a hydrocoele .
FEMALE HYDROCELE
CYST OF CANAL OF NUCK
( swelling in inguino-labial Region)
IMPORTANT THINGS :
No communication with
the peritoneum should be
visible in case of a
hydrocoele .There should be
no change with the
Valsalva maneuver .
Ultrasound is particularly
useful because of its “real-
time” nature and ability to
precisely depict superficial
structures .Ultrasound is an
excellent technique to help
exclude the presence of
bowel in the swelling as
seen in an inguinal hernia

9. Cystic focus
appreciated in
INGUINO-LABIAL
REGION ( RT SIDE)
1. NON REDUCIBLE
2. NON TENDER
3. NO SEPTAE/ DEBRIS/
LOCULI IN IT .
4. NO COMMUNICATION
WITH PERITONEUM
5. NO CHANGE WITH
VALSALVAE
6. BOWEL EXCLUDED.
FEMALE HYDROCELE
CYST OF CANAL OF NUCK
( swelling in inguino-labial Region)

10. An upper lip defect may be seen
and is best appreciated on
angled coronal scanning. A
vertical hypo-echoic region
through the fetal upper lip
usually represents the defect in
cleft lip. This finding may be
corroborated by a similar defect
of the soft tissues of the upper
lip overlying the maxilla
in the axial plane.
The palate can be examined in
the transverse (axial) plane. 3D
ultrasound may further assist in
diagnosis. It is good practice
to comment on fetal
swallowing in real time at
the time, the scan in
performed.
CLEFT LIP AND CLEFT PALATE
HYPOECHOIC DEFECT IN THE
MAXILLARY REGION
BOTH MESENCHYMAL AND BONE
DEFECT

11. The Nyberg 1995 antenatal ultrasound
classification system is divided in 5
types
•Type I: isolated cleft lip alone
•Type II: unilateral cleft lip and
palate
•Type III: bilateral cleft lip and palate
( seen as premaxillary echogenic
mass )
•Type IV: midline/median cleft lip
and palate
•Type V: facial clefts associated with
the amniotic band syndrome or
the limb-body-wall complex
An isolated cleft palate is almost
impossible to diagnose in-utero and is
not part of this classification.

12. CLEFT
LIP/PALATE
TYPE FOUR

13. The central part of testis has red color code
corroborative with differentially soft
consistency ( post torsion follow up case )

14. DIAGNOSTIC
ULTRASOUND
FOURTH EDITION
Carol M. Rumack, MD,
FACR
J. William Charboneau,
MD, FACR
Deborah Levine, MD,
FACR