Diagnostic ultrasound ( PDFDrive )

542 PART II Abdominal and Pelvic Sonography
A
B
C
D
E
FIG. 15.13 Adenomyosis. (A) Transverse TVS shows echogenic nodules (arrows). The central echogenic area in this image is the endometrium.
Striations and nodules are likely the same feature, with the term “striations” being used when more elongated in shape and “nodules” when more
spherical. (B) Sagittal TVS reveals multiple small cysts in the myometrium. (C) Sagittal TVS shows diffuse myometrial heterogeneity. In addition,
the endometrium is poorly deined. (D) Sagittal TAS demonstrates globular shape of the uterus. (E) Sagittal TAS shows asymmetrical myometrial
thickness, with the posterior myometrium thicker and heterogeneous compared with the anterior myometrium. See also Video 15.4.
these are evident on clinical examination. Small cervical polyps
may be diicult to identify sonographically unless there is surrounding
luid. At times, endometrial polyps (or endocavitary
leiomyomas) will prolapse into the cervix. he diagnosis can be
made based on visualization of the vascular stalk leading to the
prolapsed lesion in the endocervical canal (Fig. 15.14C–D, Video
15.5).
Cervical carcinoma is usually diagnosed without imaging,
but occasionally one may incidentally encounter a patient with
cervical carcinoma. Cervical carcinoma typically appears as a
heterogeneously hypoechoic solid mass (Fig. 15.14E). It may
be diicult to distinguish from a leiomyoma by ultrasound,
although increased vascularity on Doppler imaging has been
described. 104