Friday, March 25, 2011

Polycystic ovary- PCOD:

Polycystic ovaries (PCO or polycystic ovary disease- PCOD) and PCOS (polycystic ovarian syndrome) are the bane of the modern age women. A significant percentage of the female populace suffers from Polycystic ovaries. These ultrasound videos show the changes that take place in the PCO affected ovaries:

The above ultrasound video shows the right ovary of this young adult female patient. Observe the multiple cysts within the right ovary, all of which are small and located along the rim of the enlarged right ovary.

Similar change are observed in the left ovary (above).


The ultrasound video clip above shows both ovaries as we sweep across the pelvis with the endocavity sonographic probe. The uterus itself does not show prominent changes. However, the chief complaint of such patients is irregular menses with many reporting missing menstrual periods for as long as 1 to 5 months. Often medication alone cannot salvage the condition and surgical intervention is indicated, especially, when the patient wishes to conceive.
You can read and view more images of this case at:
http://www.ultrasound-images.com/ovaries.htm#Polycystic_ovaries_%28polycystic_ovary_disease-_PCOD

Wednesday, March 23, 2011

Milk of calcium cysts of the kidneys

Milk of calcium cysts must be differentiated from more ominous conditions like kidney stones and angiomyolipoma (a relatively common kidney tumor). These ultrasound videos show the typical feature of milk of calcium cysts- their tendency to gravitate to the dependent part of the cyst on postural change.


The video clip above shows the calcium salts in the right of the cyst (viewer's right), in the sitting posture.


Now observe the 2nd sonographic video clip above: the milk of calcium has shifted in position with change of the patient's position to the right lateral decubitus position.
References: http://bjr.birjournals.org/cgi/reprint/37/433/70.pdf 
Also:  http://www.ajronline.org/cgi/reprint/113/3/455.pdf
This link is also useful:  http://www.ultrasound-images.com/kidneys.htm#Milk_of_Calcium_cyst

Tuesday, March 22, 2011

Adenomyosis of the uterus

The uterus has two parts, functionally speaking, the endometrium (or the inner lining of the uterus) and the myometrium (the thick muscular wall of the uterus). During menses, a part of the endometrial lining is shed along with the menstrual blood. In women with adenomyosis there is ectopic (abnormally located) endometrial tissue located deep inside the wall of the uterus (myometrium). This ectopic (adenomyotic tissue) also undergoes menstrual bleeding resulting in severe pain within the wall of the uterus (dysmenorrhea). Many experts believe that adenomyosis is one of the leading causes of pain during menses in women. These ultrasound and color Doppler videos show marked congestion (increased vascularity) within the hyperechoic lesion in the posterior wall of the body of the uterus. This lesion represents the site of adenomyosis.


This is a transvaginal gray ultrasound video (above) showing the inhomogenous hyperechoic area in the posterior wall of the myometrium in the body of the uterus (arrows).
The color Doppler video below shows hypervascularity in the lesion:
  
This ultrasound and color Doppler video shows a transverse section of the uterus, panning the probe from superior to the inferior part of the uterus.(see below).
video   
The adenomyotic lesion is seen to compress upon the endometrial stripe also, adding to the woes of the patient.
Lastly this Power Doppler video further shows the increased vascularity/ hyperemia of the entire uterus, besides that of the adenomyotic lesion.

video  
For more on this topic: http://www.ultrasound-images.com/uterus.htm#Adenomyosis_of_uterus

Monday, March 21, 2011

Copper -T (IUCD)

Visualizing the IUCD or intra-uterine contraceptive device by sonography is perhaps the easiest and best way to determine if the IUCD is in its proper location. Normally, the copper-T should be seen with its horizontal arm in the fundus and the vertical part of the T in the body of uterus (within the uterine cavity). The ultrasound images below show the normally located IUCD



The dense white stripe seen in the uterine cavity, is the IUCD, seen in both transverse and sagittal planes.
These videos show the method of scanning the uterus to detect the IUCD:


  
Problems with IUCD or IUD (intra-uterine devices) include, migration of the IUCD/ IUD through the wall of the uterus (ie: the myometrium), to enter the wall of the uterus, by literally piercing the uterine wall, over a period of time. Other complications include infection/ sepsis of the uterus. Ultrasound imaging helps to detect all these problems accurately. Where needed, a transvaginal scan of the uterus and pelvis can help exclude such complications. In rare cases, the IUCD/ IUD might be found within the pelvis, outside the uterus.

Normal coiled nature of umbilical cord:

The normal umbilical cord is coiled with the umbilical arteries twisting around the umbilical vein in a spiral manner. This color Doppler video clip demonstrates just that:
video 

This was a 23 week old pregnancy. The placenta is anteriorly located with the cord suspended well within the abundant amniotic fluid.
See more details of this case at:
http://www.ultrasound-images.com/umbilical-cord.htm#Normal_coiling_of_the_umbilical_cord

Friday, March 18, 2011

Nuchal cord in late 3rd trimester pregnancy:

This color Doppler ultrasound video shows a color Doppler video of a single loop of type A nuchal umbilical cord:


The above youtube video showed a sagittal section of the anomaly.
Below is another color Doppler video of the same case, this time showing a axial section through the cord anomaly:


Sunday, March 6, 2011

Parotid cysts- more queries than answers:

Cysts of the parotid gland are relatively rare. However, ultrasound is useful in detecting them with ease, especially with the new high definition probes now available. These ultrasound videos demonstrate one such case:
video 
Observe carefully- there are two cysts, not one. The smaller cyst is 4mm. in size compared to the 20 mm. of the larger cyst. My personal intuition is that these are retention cysts of the parotid gland. See some more color Doppler /ultrasound videos of this case:


video 

The ultrasound features of this cystic lesion are also similar to those of a benign mass of the parotid that has undergone cystic degenerative changes (much like the central necrosis that occurs in neoplasia like fibroids of the uterus).

View more images of this case and detailed description at: http://www.ultrasound-images.com/salivary-glands.htm#Cystic_lesion_of_parotid_salivary_gland