Character – Body

Ashley Davidoff MD

Introduction

Normal Gray Scale and Power Doppler

46314c01 uterus endometrium blood flow myometrium perfusion normal anatomy USscan Davidoff MD

Junctional Zone and Outer Myometrium

In this 26 year premenstrual female a transvaginal ultrasound in the sagittal plane reveals a normal view of the uterus with characteristic premenstrual appearance. (a) The stripe is almost homogeneously echogenic and thick but also shows a hypoechoic halo of the junctional zone or inner myometrium. (salmon) The homogeneous stripe is made up from two histological layers (barely distinguished by this ultrasound)– the inner stratum functionalis (deep orange) that will shed once the spiral arteries vasoconstrict, and the outer stratum basalis (deep yellow) that will not shed, and will be the basis for regenerating the endometrium in the next cycle. The next layer as stated above is the compact myometrium – the junctional zone (aka inner myometrium) , and is followed by the thicker outer myometrium (maroon). (b)

Transverse Section Ultrasound

In this 26 year premenstrual female a transvaginal ultrasound reveals a normal transverse view of the uterus with characteristic premenstrual appearance. The stripe is homogeneously echogenic and thick but also shows a hypoechoic halo of the junctional zone or inner myometrium. (salmon) The homogeneous stripe is made up from two histological layers (not distinguished by this ultrasound)– the inner stratum functionalis (deep orange) that will shed once the spiral arteries vasoconstrict, and the outer stratum basalis (deep yellow) that will not shed, and will be the basis for regenerating the endometrium in the next cycle. The next layer as stated above is the compact myometrium – the junctional zone (aka inner myometrium) , and is followed by the thicker outer myometrium (maroon).

CT in Sagittal Section

The sagittaly reconstructed CT shows an anteverted uterus buoyed and cushioned by partly filled bladder (yellow) In this sagittal view of the uterus an ‘L” shaped structure of the uterus vagina, and the internal cavity is diagrammed in by the pink vectors of the tract.

STIR Weighted Image in Sagittal Projection

The sagittal STIR sequence from an MRI study shows the normal appearance of the uterus in a 34 year old female. The pear shaped form is exemplified together with the 3 parts of the uterus. The inner endometrium of intermediate signal, the junctional zone of low signal consisting of compacted smooth muscle with low water content, and the surrounding myometrium of smooth muscle with a higher water content.