Questions and Answers
What is the mean length of the uterus in centimeters at the age of 2 years?
What is the AP dimension of the corpus at the age of 5 years?
What is the volume of the uterus in cubic centimeters at the age of 12 years?
What is the uterine body-to-cervix ratio in the adult uterus?
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At what age does the uterus reach its adult size and configuration?
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What is the length of the postmenarcheal uterus in centimeters?
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What is the maximum AP diameter of the postmenarcheal uterus in centimeters?
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What is visible at transabdominal sonography depending on the phase of the menstrual cycle after menarche?
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What is a common feature of adnexal torsion?
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What does the twisted vascular pedicle in adnexal torsion often appear as?
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What is the earliest Doppler finding in adnexal torsion?
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Why may arterial flow still be present in ovarian torsion?
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What is a characteristic sonographic feature of isolated tubal torsion?
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Which tube is more frequently involved in isolated tubal torsion?
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What is a characteristic Doppler finding in isolated tubal torsion?
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What is the age group typically affected by isolated tubal torsion?
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What can cause the uterine fundus to appear convex during sonography?
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Which of the following is true regarding uterine morphology in both central and peripheral precocious puberty?
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What distinguishes peripheral or pseudosexual precocity from central precocious puberty?
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What is the mean ovarian volume typical for central precocious puberty?
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Which condition can NOT directly result in peripheral precocious puberty?
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What is a common characteristic of ovarian cysts or tumors in pseudosexual precocity?
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Which of these statements accurately describes the bicornuate unicollis uterus?
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What is the most common müllerian anomaly?
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In a septate uterus, what is the anatomical structure that divides the uterus?
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What distinguishes the bicornuate bicollis uterus from the didelphys uterus?
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What is the typical clinical presentation of patients with a bicornuate uterus?
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What is the primary treatment for a septate uterus, if needed?
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What characteristic differentiates the bicornuate uterus from the septate uterus?
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What is the primary risk associated with a septate uterus?
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Study Notes
Adnexal Torsion Features
- Midline position of the ovary can be observed posterior to or above the bladder.
- Twisted vascular pedicle appearance may be round or beaked, showing multiple concentric hypo- and hyperechoic stripes.
- Ipsilateral deviation of the uterus indicates the side affected by torsion.
- Acoustic enhancement signifies vascular engorgement and stromal edema.
Doppler Imaging Findings
- Little or no intraovarian venous flow is an early sign of torsion.
- Absent arterial flow and reversed diastolic flow may also indicate torsion.
- Presence of arterial flow can occur due to dual blood supply from uterine and ovarian arteries.
- Diagnosis of torsion can be suggested with typical gray-scale appearance regardless of color flow pattern.
Isolated Tubal Torsion
- Rare cause of acute lower quadrant pain, more common in girls at puberty.
- Right fallopian tube is more frequently involved than left.
- Sonography displays a dilated fallopian tube, possibly with low-level internal echoes and thickened walls.
Uterine Measurements in Prepubertal Girls
- Maximum AP diameter and volume of the uterus vary with age, with specific measurements outlined for ages 2 to 13.
- Uterine body-to-cervix ratio approaches 1.5:1 by puberty.
Pubertal Uterus Development
- Uterine fundus elongates and thickens during puberty, yielding a pear-shaped configuration.
- Uterine dimensions at onset of menarche are approximately 5 to 8 cm in length and 1.6 to 3 cm in maximum AP diameter.
Endometrial Physiology
- The endometrium comprises a central functional layer that thickens and sheds, and a peripheral basal layer that remains intact.
- Endometrial thickness varies with menstrual cycle phases, from thin (up to 4 mm) during menstruation to 15-16 mm during the secretory phase.
Bicornuate Uterus
- Characterized by a concave indentation of the uterine fundus, dividing the organ into two horns.
- The bicornuate uterus does not typically require surgical intervention, and affected patients are usually asymptomatic.
Septate Uterus
- Most common Müllerian anomaly resulting from incomplete resorption of the septum between Müllerian ducts.
- Patients often asymptomatic, though spontaneous abortions are more common; treatment involves septum resection.
Precocious Puberty
- Central precocious puberty involves premature development due to pituitary hormones, leading to enlarged ovaries and adult uterine morphology.
- Peripheral precocious puberty arises from gonadotropin-independent estrogen production, maintaining low serum gonadotropin levels.
- Causes include functioning ovarian cysts, adrenal tumors, and estrogen ingestion; ultrasound aids in assessing size and morphology of reproductive organs.
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Description
Identify the characteristics of adnexal torsion in ultrasound imaging, including midline ovary position, twisted vascular pedicle, and acoustic enhancement.
