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Thomas C. Winter, MD
Ultrasound of the Endometrium
Thomas C. Winter, MD
01/29/2011 | Time : 43 min
About This Lecture:

Topics mentioned in this video : Ultrasound of the endometrium, Why we worry? , Endometrial cancer, Terminology, Endometrial measurement: technique, How to measure the endometrium: transvaginal, Exclude hypoechoic inner myometrium, Endometrial fluid, Sweep entire endometrium, Visualize entire endometrium, Don’t accept indistinct endometrial margins, Measurement technique, Scenario I: premenopausal, Endometrial appearance: immediately post-menses or post menopausal, Endometrial appearance: proliferative, Endometrial appearance: peri-ovulatory, Endometrial appearance: late secretory (luteal), 15 mm not perfect threshold, Scenario II: PMB, Scenario III: PMB on HRT, 55 year old on unopposed estrogen,, Scenario IV: PM but not bleeding, Scenario V: tamoxifen, Tamoxifen polyp, Numeric summary, TVUS: atrophy, TVUS: polyps, TVUS: fibroids, TVUS: endometrial cancer, Alternative procedures: hysterosalpingogram (HSG), Alternative procedures: dilation and curettage (D&C), Alternative procedures: endometrial biopsy, Alternative procedures: hysteroscopy, Saline infusion sonohysterography (SIS), SIS overview, Is SIS overkill? Is TVUS alone good enough?, Polyp nicely shown during SIS
SIS indications, SIS indications: discordance, SIS: primary goals, SIS: technique, Why SIS during days 4-7, SIS training, SIS: risks, SIS: equipment, Equipment: the catheter, How to perform SIS: choose correct speculum, How to perform SIS: insert speculum correctly, Speculum schematic, How to perform SIS: pass catheter, How to perform SIS: video example, Pull out imaging, Try catheter in cervical canal, Cervical balloon placement, 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, Which is the malignant cause of this patient’s PMB?, SIS: endometrial polyps, SIS: fibroids, SIS: endometrial hyperplasia, SIS: endometrial cancer, SIS: endometrial cancer incomplete distension, SIS primary goal: focal vs. diffuse, Which is not endometrial cancer?, Miscellaneous: SIS tamoxifen, Miscellaneous: SIS infertility, Miscellaneous: SIS infertility adhesions, Miscellaneous: SIS infertility tubal anatomy, Miscellaneous: SIS intervention, SIS vs. other standards, SIS vs. hysteroscopy, Ultrasound of 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 infused 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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