Best Fsearchr Much 3 Org 8search6search8search1 Author 83_search Much ssearcha Dating c Moritoyamachan rsearch3search8 Matchmaking 3search8 Best 60 Matchmaking 9search5
search searcha
i Author g Author usearchMsearchc1328860891583_R 1328860891583_R D Matchmaking ti
g Dating rsearchA Dating t Author or Blog R6 Author 89 Matchmaking 5search3_search/searchu1328860891583_Rt Blog asearcho Much n1328860891583_R searchi
e 1328860891583_Rli Dating s1328860891583_Rof Moritoyamachan t Moritoyamachan isearch Author a Matchmaking esearchs Matchmaking esearch
2010/05/fibroid-of-cervix-in-19-week-pregnancy.html
This young adult female patient showed a large hyperechoic well defined, solid mass inside the body of uterus, in close relation to the endometrial cavity. Sonography of the uterus shows that the mass is possibly within the endomterial cavity. Power Doppler image (top-right) shows that there is a rim of vascularity around the mass. The mass measures more than 4 cms. in size. These ultrasound findings/ images suggest submucous fibroid of the uterus. The main differential diagnosis in this case is endometrial polyp. However, the larger size (polyps are usually less than 2 cms. in size) and lack of a single vascular pedicle (seen in polyps) suggest submucous fibroid. Images taken using a Toshiba Nemio-XG ultrasound system by Joe Antony, MD, India.
Reference: cgi/reprint/26/7/941 (free article and images).
Case-2: Submucous fibroid: (3-D imaging):
Here are some interesting ultrasound images if a submucous fibroid using a new technique called Volume contrast imaging. This renders 2 D image sections of a volume image (3-D image) acquired of the part being studied (here the Uterus). (Images courtesy of Dr. PK Srivastava, India).
This technique appears to be an application of 3D/ 4D ultrasound. Observe how volume contrast ultrasound images of the uterus bring out the fine detail of the submucous fibroid and its margins. The image on lower right shows the 3D ultrasound appearance of the disease.
This was a young adult female patient with a relatively large submucous fibroid bulging into the uterine cavity. Transabdominal ultrasound image (left) shows fluid within the uterine cavity bringing out the mass in contrast. This fluid was naturally present in the endometrial cavity possibly the result of endometritis. Color Doppler image (right) shows vascular pedicle supplying the fibroid. Images are courtesy of Ravi Kadasne, MD, UAE. The machine used here is the Toshiba Aplio.
Sonography of the pelvis done on this young adult female patient revealed a large, solid, non-calcific well defined mass located in the anterior wall of the body of uterus. The mass shows absence of central necrosis or infiltration of the bladder wall, though it compresses upon the urinary bladder. Since the mass lies just below the serosal layer of the uterus, these images suggest subserosal fibroid of the uterus. Such large, subserous fibroids of the uterus can cause pain and symptoms due to pressure effect on the urinary bladder, rectum, ureters etc. The Power Doppler image (bottom), shows stretching of the vessels around the rim of the fibroid.
Reference: cgi/reprint/43/513/602
This patient complained of pain in the lower abdomen and was suspected to have a disease of the ovaries or uterus. Sonography of the uterus shows a large, solid mass, 7.5 x 7.7 cms., in the lower part of the uterus, mainly involving the isthmic region (the junction between the body and cervix of the uterus). The mass shows typical features of in intramural fibroid of the uterus. Diagnosis: isthmic fibroid of the uterus. Isthmic fibroids can cause infertility and repeated abortions. Power Doppler image shows the vessels curving around the isthmic mass. Ultrasound images of isthmic fibroid taken using a Nemio-XG ultrasound system by Joe Antony, MD.
Interligamentous fibroid or fibroid within broad ligament:
Sometimes a fibroid can grow laterally into the region between the two layers of the broad ligament, These ultrasound images show a solid mass to the right of the body of uterus. The mass is non calcific and shows no degenerative changes and appears to occupy the right broad ligament (arrows). This suggests a right broad ligament fibroid (also called interligamentous fibroid). Such fibroids can be difficult to remove surgically due to the vessels passing through the broad ligament.
Reference:1) fgwh/wh1ch07.htm (free article)
2) archive/vol8a/BroadLigament.pdf (free article)
This patient was a young lady with pelvic pain. Ultrasound images show-
Transabdominal ultrasound: Transvaginal ultrasound:
The transabdominal ultrasound clearly shows a rounded calcific mass (along the rim), in right adnexal region. transvaginal sonography confirms the finding. The transvaginal ultrasound appears more accurate in measuring the size of the calcific broad ligament fibroid (3 cms.). But there is more.....
This image (transabdominal) shows a cystic area anteriorly: Now see the transvaginal image:
The transabdominal ultrasound image shows a cystic lesion anterior to the uterus. The question- is this a cystic mass? And where does it arise from? The transvaginal image shows this to the cervix with multiple Nabothian cysts studding it. The uterus is markedly retroflexed and retroverted, causing the posterior surfaces of the fundus and the cervix to appose each other. The retroflexion is so severe that the anterior surface of the body of uterus faces posteriorly with the fundus lying posterior to the cervix! This was the cause of the diagnostic dilemma.
Another transvaginal ultrasound image showing the cervix with multiple Nabothian cysts:
F) Degenerative changes in fibroid (degenerating fibroid):
Fibroids can undergo various degenerative changes, especially when large. This fibroid of the uterus measures 11.2 cms. and shows multiple hypoechoic and hyperechoic patchy areas (see ultrasound images below).
Color and Power Doppler images are shown below:
There is little vascularity within the huge tumor of the upper uterus (fundus and body). Degenerative changes can take place in fibroids with areas of necrosis and hemorrhage and result in varying appearances from cystic to inhomogenous appearances. In fact, it may be difficult to differentiate a large complicated ovarian cyst from a degenerated fibroid.
References: cgi/content/long/25/5/671
