0:00

This is an MRI of the abdomen and

0:02

pelvis in a patient with a very

0:04

early first-trimester pregnancy.

0:07

These are axial T2-weighted images

0:09

of the pelvis, and as we move toward

0:11

the pelvic inlet, we begin to see

0:13

the gravid uterus come into view.

0:16

We can see this layer of T2

0:19

heterogeneous myometrium surrounding

0:22

the distended endometrial cavity, which

0:24

contains a T2-bright gestational sac.

0:28

This comma-shaped structure within

0:30

the gestational sac is the embryo.

0:33

We can see that the amniotic fluid volume

0:36

is qualitatively normal for this patient.

0:39

We also see the ovaries in this patient.

0:42

Here's the left ovary.

0:43

It's lateral and anterior to the uterus along

0:46

the course of the anterior iliac vessel.

0:49

Here's the right ovary.

0:50

It's located posterior to the uterus in this

0:53

patient, which is fine because the ovaries

0:55

are mobile structures within the pelvis.

0:58

This peripherally T2-dark structure within

1:01

the right ovary is a corpus luteum, so we can

1:04

estimate that this patient likely ovulated on

1:07

the right side in the context of this pregnancy.

1:11

These are coronal T2-weighted

1:12

images of the abdomen and pelvis.

1:14

Again, we can see the mildly enlarged gravid

1:18

uterus with T2 heterogeneous myometrium and the

1:23

gestational sac within the endometrial cavity.

1:26

We can see very early limb buds within

1:30

this tiny embryo in addition to a yolk sac.

1:34

And again, this is the left ovary, which

1:36

contains T2 hyperintense follicles.

1:39

And this is the right ovary, which contains

1:42

that peripherally T2-dark corpus luteum.

1:46

Lastly, let's evaluate this early first

1:48

trimester pregnancy on sagittal T2-weighted MR.

1:52

Again, we see the gravid uterus with the

1:54

gestational sac containing T2-bright fluid.

1:57

This is our small early embryo.

1:59

And what I'd like to point out on the sagittal

2:01

images is the exquisite pictures that we

2:05

can get of the cervix and cervical canal.

2:07

Again, this is the anterior lip

2:09

and posterior lip of the cervix.

2:11

We see a very small amount of

2:13

fluid within the cervical canal.

2:14

That's normal.

2:16

But the internal os is closed, which is

2:18

important for us to document, particularly

2:20

in the first trimester of pregnancy.