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. 777
Tubal Ectopic Pregnancy Diagnoses: Female Pelvis (Left) Transverse transvaginal ultrasound shows a gestational sac outside of the adjacent empty uterus ſt. Note the embryo in the gestational sac st. (Right) Transverse oblique M-mode ultrasound in the same patient shows cardiac activity in the live ectopic. (Left) Sagittal oblique transvaginal ultrasound shows a heterogeneous mass in the right adnexa . (Right) Transverse color Doppler ultrasound in the same patient shows a ring of vascular flow st, which aides in localization of the tubal ring ſt that is obscured by the surrounding clot . (Left) Magnified transverse ultrasound of the tubal ring in the same patient demonstrates an embryo (calipers) in the ruptured ectopic. (Right) Sagittal transvaginal ultrasound shows the empty uterus st with a large amount of echogenic free fluid ſt in the cul-de-sac. 778
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Tubal Ectopic Pregnancy<br />
Diagnoses: Female <strong>Pelvis</strong><br />
(Left) Transverse transvaginal<br />
ultrasound shows a<br />
gestational sac outside of<br />
the adjacent empty uterus ſt.<br />
Note the embryo in the<br />
gestational sac st. (Right)<br />
Transverse oblique M-mode<br />
ultrasound in the same patient<br />
shows cardiac activity in the<br />
live ectopic.<br />
(Left) Sagittal oblique<br />
transvaginal ultrasound shows<br />
a heterogeneous mass in the<br />
right adnexa . (Right)<br />
Transverse color Doppler<br />
ultrasound in the same patient<br />
shows a ring of vascular flow<br />
st, which aides in localization<br />
of the tubal ring ſt that is<br />
obscured by the surrounding<br />
clot .<br />
(Left) Magnified transverse<br />
ultrasound of the tubal ring in<br />
the same patient<br />
demonstrates an embryo<br />
(calipers) in the ruptured<br />
ectopic. (Right) Sagittal<br />
transvaginal ultrasound shows<br />
the empty uterus st with a<br />
large amount of echogenic<br />
free fluid ſt in the cul-de-sac.<br />
778