Quiz- a case of metrorrhagia in adolescent:

This 15 year old female adolescent has metrorrhagia (irregular menses). What are your findings based on these ultrasound images? Fig-1 and 2: B- mode ultrasound images-sagittal section of the uterus:

 Fig-3: Color Doppler image of the uterus:

Fig-4:Ultrasound images of the ovaries:

Answer: these images suggest endometrial hyperplasia due to unopposed estrogenic activity.

Fibroid complicating a possible ectopic gestation

This young lady has bleeding P/V with a history of  6 weeks amenorrhoea. Ultrasound images are shown below- the top few images being transabdominal ultrasound images, followed by endocavity sonography.
A large mass is seen above the uterine fundus- is it a pedunculated fibroid?

Note the presence of fluid in the cul de sac: see below:

It gets more intriguing as the fluid is echogenic in the transvaginal ultrasound images below suggesting bloody matter in the cul de sac and left adnexal regions. Is there a left adnexal mass within the thickened left Fallopian tube? The mass above the fundus looks like a typical fibroid, possibly pedunculated. The uterine cavity is empty with no sign of a gestation sac. Is the fluid the result of an ectopic in the left fallopian tube or is it due to ruptured hemorrhagic cyst?

Transvaginal color Doppler images of this patient show limited vascularity around and in the left adnexal mass which measures 2 cms. in size:

For more on sonography of ectopic pregnancy visit:
http://www.ultrasound-images.com/early-pregnancy.htm#Right_ectopic_pregnancy

Quiz- early gestation sac with what else

This is a 7 week gestation with a viable embryo seen in the intrauterine gestation sac. But what else do you find? And what is that posterior to the uterus? (These ultrasound images were taken with a Philips HD 15 ultrasound system):

Diabetic gangrene of the left foot- arterial doppler

Left femoral artery spectral doppler tracing- shows pulsus bigeminus (pairs of heartbeats with the 2nd pulse weaker than the first, followed by a long pause).
The spectral doppler trace itself shows normal waveform.

The left popliteal artery- dampened waveform- moderate stenosis

Left posterior tibial artery

Left peroneal artery

Left anterior tibial artery. All the arteries below the left knee show significant dampening of flow s/o moderately severe stenosis of the left anterior and posterior tibial arteries and peroneal artery.

Interesting venous doppler of short saphenous vein

What do you think of the appearance of this vein- looked like the short saphenous vein, arising a little higher up from the popliteal vein: There was hardly any flow in the short saphenous vein:
What do you think can cause that doughnut appearance?

Varicose veins in the left calf (image above).
Answer: this is a patient of severe varicose veins of the left leg with partial thrombosis of the left short saphenous. There is a partial recanalization of the short saphenous vein (SSV) through the center of the venous thrombus- giving the Lt SSV the typical doughnut appearance. The thrombus appears as echogenic (mildly echogenic) material near the wall of the short saphenous vein. Also note the very poor to almost absent flow in the SSV.

Another case of BPH- 3D images

Yet another case of benign prostatic hypertrophy. More 3 D images with the Philips HD 15:
3D image of the enlarged prostate with intravesical enalrgement:

Mild bilateral hydronephrosis: 

Benign hypertrophy of prostate- 3D ultrasound images

Some 2D and 3D ultrasound images of benign hypertrophy of the prostate- 2D and 3D ultrasound images of the prostate and bladder:
Surface rendering of the prostate shows this organ to the bottom of the image. The machine used here is the Philips HD 15....

2D Image of the enlarged prostate:

 

3D ultrasound images of benign enlargement of prostate: that is the orange colored image to the bottom right of the group of 4 images: