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Pregnancy with adenomyosis and leiomyoma with component of pelvic congestion
1. ADENOMYOSIS MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARH MERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH 22 YEAR OLD FEMALE WITH POG OF 5WKS . EPISODIC PAIN IN THE LOWER ABDOMEN.
3. FEATURES OF ADENOMYOSIS Echogenecity of mass---------- Hyperechoic Borders of the mass------------ill -defined Vascularity of the lesion------- Penetrating Size of uterus---------------------Bulky with asymmetrical lobulations ( anterior and posetrior). Junctional zone-------------------Thick. ( >8mm ( 8-12mm) >12mm) ( MR sagittal plane T2w sequence gives best assesment of junctional zone) Subendometrial / Intramyometrial cysts -Present .
4. FEATURES OF LEIOMYOMA Echogenecity of mass---------- Hypoechoic Borders of the mass------------Defined Vascularity of the lesion------- Peripheral Junctional zone------------------- Normal. Subendometrial / Intramyometrial cysts- Not present .
11. CONGESTED TORTUOUS VESSELS – INTRAMYOMETRIAL . PENETERATING PATTERN FOCAL HYPOECHOIC AREAS APPRECIATED IN THE MYOMETRIUM WITH DEFINED BORDERS – CORROBORATIVE WITH SMALL LEIOMYOMA.
12. G SAC WITH NO FETAL NODE/ NO YOLK SAC. CORROBORATES WITH POG 5WKS ODAYS ......FOLLOW UP FOR VIABILITY HETEROGENOUS ECHOPATTERN OF THE MYOMETRIUM
13. MAGNIFIED VIEW OF THE G SAC SINGLE LINER ADENOMYOSIS CAN PREDISPOSE TO INTRAMYOMETRIAL ECTOPIC PREGNANCY
19. LESSON LEARNT Differentiate between Adenomyosis and Leiomyoma. Appreciate peneterating pattern form the Peripheral arterial tree. Differentiate focal from diffuse form of the adenomyosis.
