1) Thickened endometrium with tiny endometrial/subendometrial cystic
foci. In the setting of abnormal uterine bleeding, endometrial
pathology such as polyp or hyperplasia is suspected and tissue
sampling is suggested. Focal adenomyosis may also be considered and
MRI may provide further evaluation.
2) Right ovarian parenchyma not clearly identified. Apparent cystic
structure within the right adnexa likely represents hydrosalpinx
along with possible ovarian cysts. Clinical correlation is
exclude ovarian torsion. Additionally, a 6-week follow-up with
ultrasound is recommended.
CLINICAL INDICATION: Pelvic pain and heavy bleeding, rule out
fibroids. The patient's BETA-HCG level is negative.
INTERPRETATION: Pelvic ultrasound demonstrates a heterogeneous
uterus measuring 10.7 x 6.2 x 6.9 cm with possible tiny cystic foci
in the endometrial/subendometrial region. The endometrium is
thickened up to 2 cm. There is a small anterior uterine body fibroid
measuring 2 x 1.7 x 2.7 cm. The right adnexa contains a cystic
structure incompletely characterized on this transabdominal portion
of the exam.
Transvaginal ultrasound was performed to evaluate the adnexa and
uterus. The left ovary measures 1.9 x 1.7 x 1.9 cm with normal color
and spectral Doppler flow. There are multiple cystic structures
within the right adnexa measuring up to 3.8 x 2.2 cm. There is a
cystic tubular component measuring up to 2.0 cm in width probably
representing hydrosalpinx. There may be additional cysts. Normal
right ovarian tissue is not clearly visualized. There is no
excessive free fluid in the cul-de-sac.
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