Darien S. Larry
Hilton Head Hospital
Clinical Education IV/RADS 4634
age: 15 gender: female race: Caucasian clinical symptoms : irregular menstrual cycle
No other pertinent medical history was provided Patient Assessment
• Name and date of patient was confirm
• Patient was asked before starting the exam...
If she had an ultrasound before?
If she had a full bladder?
When was the first date of her last menstrual period?
If she ever been pregnant?
• Patient was told before starting the exam...
–. Gel was warm and will not stain clothes
–. Radiologist will read exam and will send a report to the ordering physician • No precautions were needed due to the patient being an outpatient Sonographic Application
• A pelvic non-OB complete ultrasound was ordered for an irregular menstrual cycle by
Adrienne Crow, MD.
Pertinent Laboratory Tests
• No laboratory values were given; however,...
• Serum concentrations of estrogen/progesterone can be useful in evaluating ovulatory function.
• Abnormally high serum white blood cell count (>
10,000 per mm^3 ) is indicative of an infectious process (Curry & Tempkin, 2012)
• GE Logiq 9 was used during this exam.
• Special/advanced imaging features used included: –
Speckle Reduction Imaging High Definition
Coded Harmonic Imaging
• Last quality assurance check performed: August 14,
2014 by BioMed representative: Walter
• Transducer type: Curvilinear 4 MHz
• Receiver gain: 50 dB
• TGC levels were not manipulated for this exam
• Focal point was below level of interest
• Power: 100 %
• MI: 1.2
• TI: 0.3
• Frame rate: 13 Hz
• Dynamic range: 69 dB
• Axial resolution was degraded due to the usage of a lower frequency transducer.
• Lateral resolution was degraded due to the usage of only one focal point.
• Contrast resolution was improved due to the usage of harmonic imaging.
• Temporal resolution was improved due to the usage of only one focal point.
• Spatial resolution was horrible because the image did not exhibited great detail (Edelman, 2012).
Ultrasound Description of Pathology
• May demonstrate dilated fallopian tube where altered blood products within the tube often demonstrate homogeneous low-level echoes.
– Similarity: Dilated fallopian tube(s)
– Difference: Appearance of multicystic or fusiform mass in adnexal area
– Similarities: Dilated fallopian tube(s)
– Difference: May appear as complex mass in adnexal area
Other Pertinent Diagnostic Exams
Performed & Results
• Role in ultrasound exam: observer
• No other pertinent diagnostic exams were performed. • However, CT and MRI are extremely important diagnostic tools to evaluate the female pelvis.
(Curry& Tempkin, 2012)
Etiology and Incidence
• Causes of hematosalpinx includes:
tubal ectopic pregnancy endometriosis pelvic inflammatory disease (PID) uterine cervical stenosis
• The incidence is difficult to estimate because hematosalpinx is often associated with chronic salpingitis or a tubal pregnancy and may not be included in the final diagnosis.
Normal Anatomy Images
Normal Anatomy Images bladder endo vagina cervix
Retrieved from: http://www.msdlatinamerica.com/ebooks/CoreC urriculumTheUltrasound/sid168129.html
Normal Anatomy Images
Retrieved from: http://calsprogram.org/manual/volume3/Se ction28/Ultrasound/03US2EmergencyUSTechniques13.html
Differential Diagnosis Images
SAG LT ADNEXA
Retrieved from: http://sonoworld.com/CaseDetails/Hydrosa lpinx.aspx?ModuleCategoryId=468
TRANS LT ADNEXA