Ultrasound report:Comparison: CT pelvis of 9/7/04
Findings: The uterus is top normal in size. However, there are multiple intramural masses identified, with at least four measurable masses in the myometrium. There is a mass within the lower left uterine segment anteriorly, measuring 2.1 x 1.5 x 1.3 cm. There is a hyperechoic mass within the anterior mid body in the midline, measuring 1.9 x 1.6 x 1.6 cm. There is a slightly hyperechoic mass along the right side near the fundus measuring 1.9 x 1.4 x 1.5 cm. There is an 2.0 x 1.6 x 1.2 cm. hypoechoic mass in the posterior lower uterine segment. Endometrial stripe appears normal.
Both ovaries are enlarged. Within the right ovary, there is a complex cyst, containing low-level internal echoes and a 13 mm intramural nodule. This complex cyst measures 4.6 x 3.0 x 4.7 cm. Previous ct showed a right adnexal cyst measuring 3.6 x 2.6 cm.
The left ovary also contains a complex cyst, with low-level internal echoes, irregular shape, and possible small mural nodule, measuring 2.5 x 1.9 x 1.9 cm. Previous CT showed a left adnexal cyst, measuring 1.8 x 1.6 cm. There is a second small complex cyst on the left, with diffuse internal echoes, measuring 0.9 x 0.9 x 0.8 cm No other adnexal masses are seen, and ther is no evidence of free fluid.
Impression:
1. Myomatous uterus. Several of the myomas are hyperechoic, which suggests the possibility of degeneration, possibly lipomatous degeneration.
2. Complex ovarian cyst bilaterally. These were present previously, but may have enlarged slightly, especially on the right. Possible etiologies include endometriomas or ovarian neoplasm, either benign or malignant. MRI may be useful to evaluate the possibility that these represent endometriomas.