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Questions and Answers
What is the mean length of the uterus in centimeters at the age of 2 years?
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 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 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?
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?
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?
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?
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?
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?
What is a common feature of adnexal torsion?
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What does the twisted vascular pedicle in adnexal torsion often appear as?
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?
What is the earliest Doppler finding in adnexal torsion?
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Why may arterial flow still be present in ovarian torsion?
Why may arterial flow still be present in ovarian torsion?
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What is a characteristic sonographic feature of isolated tubal torsion?
What is a characteristic sonographic feature of isolated tubal torsion?
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Which tube is more frequently involved in isolated tubal torsion?
Which tube is more frequently involved in isolated tubal torsion?
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What is a characteristic Doppler finding in isolated tubal torsion?
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?
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?
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?
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?
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?
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?
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?
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?
Which of these statements accurately describes the bicornuate unicollis uterus?
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What is the most common müllerian anomaly?
What is the most common müllerian anomaly?
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In a septate uterus, what is the anatomical structure that divides the uterus?
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?
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?
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?
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?
What characteristic differentiates the bicornuate uterus from the septate uterus?
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What is the primary risk associated with a septate uterus?
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.
