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Thomas C. Winter, MD
Ultrasound of the Endometrium
Thomas C. Winter, MD
03/08/2015 | Time : 44 min
About This Lecture:

The speaker discusses current methods in evaluating the endometrium. Discuss proper technique that should be used in measuring the endometrium. Discuss the indications for saline infusion sonohysterogram

Topics mentioned in this video : Ultrasound of the endometrium, In the fields of observation chance favors only the prepared mind, I could never get into medical school with the proposed new standards, Why we worry? , Advanced endometrial cancer in a 35 yo, Terminology, Endometrial measurement: technique, How to measure the endometrium, How to measure the endometrium: transvaginal, How to measure the endometrium , Ultrasound of the endometrium, What is an abnormal endometrium? Scenario 1 , Endometrial appearance: Immediately post menses or post menopausal , Endometrial appearance: proliferative (follicular), Endometrial appearance: peri-ovulatory, Endometrial appearance: late secretory (luteal), Endometrial appearance: ULN 15mm is not a perfect threshold, Endometrial appearance: avoid false positives – scan day 4-7, What is an abnormal endometrium? Scenario II: PMB, , What is an abnormal endometrium? Scenario III: PMB on HRT , Sonographic image, What is an abnormal endometrium? Scenario IV: PM but NOT bleeding , ,What is an abnormal endometrium: Scenario V: tamoxifen, Tamoxifen , Cystic endometrium on tamoxifen, Tamoxifen polyp, What is an abnormal endometrium? Numeric summary, Ultrasound of the endometrium , TVUS: atrophy, TVUS: polyps, TVUS: fibroids, TVUS: endometrial cancer, Ultrasound of the endometrium , Alternative procedures: hysterosalpingogram (HSG), Alternative procedures: dilation and curettage (D&C), Alternative procedures: endometrial biopsy, Alternative procedures: hysteroscopy, Ultrasound of the endometrium , Saline infusion sonohysterography (SIS), SIS overview, Is SIS overkill? Is TVUS alone good enough?, Sonographic image, Is SIS overkill? Is TVUS alone good enough?, SIS indications, SIS indications: discordance, SIS: primary goal, SIS: technique, ,Why SIS during days 4-7, SIS: risks, SIS: equipment, Equipment: the catheter, How to perform an SIS: choose correct speculum, How to perform an SIS: insert speculum correctly , Images, Insert speculum correctly , How to perform SIS: pass the catheter, Sonographic images, How to perform SIS: video example, Pull out imaging, Try catheter in cervical canal, Sonographic image, ,SIS failures, SIS false positives and problems, SIS false positives and problems: air bubbles, SIS false positives and problems: balloon obscuring LUS, SIS false positives and problems: grunge mimicking focal mass, SIS false positives and problems: blood clots mimicking focal mass, SIS false positives and problems: mechanical shearing of endometrium, SIS technology: color Doppler and focal lesions, SIS technology: 3D, SIS: endometrial polyp, SIS: endometrial polyps: 2nd polyp not seen until balloon deflation, SIS: fibroids, SIS: endometrial hyperplasia, SIS: endometrial cancer, SIS: endometrial cancer incomplete distension, SIS: endometrial cancer, SIS primary goal: focal vs. diffuse, Misc: SIS tamoxifen, Misc: SIS infertility, Misc: SIS infertility adhesions, Misc: SIS infertility tubal anatomy, Misc: SIS RPOC, Misc: SIS intervention, SIS vs. other standards, SIS vs. hysteroscopy, Ultrasound of the endometrium, Summary – “take home”, Thank you ,

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Keywords : 3D ultrasound, abnormal uterine bleeding, atrophic endometrium, cervical canal, cine mode, color Doppler, D&C, dilation and curettage, DUB, dysfunctional uterine bleeding, endometrial blood clot, endometrial canal, endometrial cancer, endometrial cavity, endometrial fluid, endometrial hyperplasia, endometrial mass, endometrial polyp, endometrial thickness, endometriosis, endometritis, endometrium, HSG, Hydrosalpinx, hysterosalpingogram, hysteroscopy, lower uterine segment, LUS, luteal phase, mechanical shearing of endometrium, myomectomy, peri-ovulatory phase, PMB, postmenopausal bleeding, proliferative phase, saline infusion sonohysterography, secretory phase, SIS catheter, SIS, speculum, stenotic cervix, submucosal fibroid, submucosal myoma, tamoxifen side effects, tenaculum, three-dimensional ultrasound, transvaginal ultrasound, TVUS, uterine perforation

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