Diagnostic Ultrasound - Abdomen and Pelvis

Tubal Ectopic Pregnancy
(Left) Transverse transvaginal
ultrasound shows a tubal ring
adjacent to the right ovary
ſt. Applying pressure with the
transducer while scanning in
this region confirmed that the
ring-like mass moved separate
from the ovary. Note its
hyperechoic appearance
relative to the ovary and the
corpus luteum below. (Right)
Transverse oblique
transvaginal ultrasound shows
echogenic bowel loops ſt
obscuring the tubal ring of
an ectopic pregnancy adjacent
to the right ovary . Note the
yolk sac (YS) in the gestational
sac st.
Diagnoses: Female Pelvis
(Left) Transverse transvaginal
ultrasound shows a thickwalled
cystic structure
within the left ovary ſt,
compatible with a corpus
luteum. Applying pressure
with the transducer while
scanning in this region
confirmed that this structure
moved with the ovary. Note its
hypoechoic appearance
relative to the tubal ring
above. (Right) Transverse
color Doppler transvaginal
ultrasound shows the "ring of
fire" associated with the
corpus luteum in the left ovary
ſt.
(Left) Transverse oblique
transvaginal ultrasound shows
a small, subtle echogenic ring
posterior to the right ovary
ſt. The absence of pelvic fluid
and lack of associated mass
suggest the tube is intact.
Methotrexate (MTX) was used
for treatment. (Right) Followup
transvaginal ultrasound in
the same patient shows
interval growth of the
gestational sac in the right
adnexa, which now contains a
YS st and is compatible with
MTX treatment failure.
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