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MR Imaging of Retained Products of Conception

Jaime B. Noonan1, Fergus V. Coakley2, Aliya Qayyum2, Benjamin M. Yeh2, Louis Wu3 and Lee-may Chen4

1 Emory University School of Medicine, 1440 Clifton Rd., N.E., Atlanta, GA 30322-4510.
2 Department of Radiology, Abdominal Imaging, University of California San Francisco, 505 Parnassus Ave., Box 0628, San Francisco, CA 94143-0628.
3 Department of Radiology, University of Toronto, 30 Bond St., Toronto, ON M5B 1W8, Canada.
4 Department of Gynecologic Oncology, University of California San Francisco, San Francisco, CA 94143-0628.



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  		Fig. 1A. —38-year-old woman with fever 3 days after dilatation and curettage was performed for postpartum bleeding 7 weeks after vaginal delivery at term. Serum ß-human chorionic gonadotropin level was 6 mIU/mL. Sagittal T2-weighted MR image (TR/TE, 4000/85) of pelvis shows retroflexed uterus with intracavitary mass (arrow) with heterogeneous signal intensity.

 


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  		Fig. 1B. —38-year-old woman with fever 3 days after dilatation and curettage was performed for postpartum bleeding 7 weeks after vaginal delivery at term. Serum ß-human chorionic gonadotropin level was 6 mIU/mL. Sagittal T1-weighted MR image (150/4.2) obtained after IV administration of gadolinium shows hypointense predominantly nonenhancing mass with focal areas of enhancement (arrows).

 


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  		Fig. 2A. —36-year-old woman with vaginal bleeding, abdominal pain, and negative findings on urine ß-human chorionic gonadotropin test 12 weeks after elective termination of pregnancy. Sagittal T2-weighted MR image (TR/TE, 4000/85) shows heterogeneous mass (arrow) in uterine cavity. Note obliteration of overlying junctional zone with thinning of myometrium at uterine fundus.

 


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  		Fig. 2B. —36-year-old woman with vaginal bleeding, abdominal pain, and negative findings on urine ß-human chorionic gonadotropin test 12 weeks after elective termination of pregnancy. Sagittal T1-weighted MR image (150/4.2) obtained after IV administration of gadolinium shows areas of brisk enhancement (arrow) within intrauterine mass. Note presence of fluid (asterisk) in upper vagina due to persistent postpartum hemorrhage.

 


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  		Fig. 3A. —32-year-old woman with vaginal bleeding and serum ß-human chorionic gonadotropin of 45 mIU/mL 2 weeks after spontaneous abortion. Axial T2-weighted MR image (TR/TE, 4000/85) shows irregular uterine mass (black arrow) of heterogeneous intensity obliterating most of junctional zone with marked thinning of myometrium (white arrow).

 


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  		Fig. 3B. —32-year-old woman with vaginal bleeding and serum ß-human chorionic gonadotropin of 45 mIU/mL 2 weeks after spontaneous abortion. Sagittal T1-weighted MR image (150/4.2) obtained after IV administration of gadolinium shows areas of brisk enhancement (arrow) in intrauterine mass.

 


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  		Fig. 4A. —33-year-old woman with bicornuate unicollis uterus and persistent vaginal bleeding 8 weeks after spontaneous abortion at 16 weeks' gestation. Two attempts at aspiration of uterine contents had been unsuccessful. Serum ß-human chorionic gonadotropin level was 15 mIU/mL. Coronal T1-weighted unenhanced MR image (TR/TE, 150/4.2) shows partially hyperintense mass (arrow) in right cornu.

 


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  		Fig. 4B. —33-year-old woman with bicornuate unicollis uterus and persistent vaginal bleeding 8 weeks after spontaneous abortion at 16 weeks' gestation. Two attempts at aspiration of uterine contents had been unsuccessful. Serum ß-human chorionic gonadotropin level was 15 mIU/mL. Axial T2-weighted MR image (4000/85) shows irregular mass (arrow) in right cornu associated with thinning of myometrium.

 


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  		Fig. 4C. —33-year-old woman with bicornuate unicollis uterus and persistent vaginal bleeding 8 weeks after spontaneous abortion at 16 weeks' gestation. Two attempts at aspiration of uterine contents had been unsuccessful. Serum ß-human chorionic gonadotropin level was 15 mIU/mL. Coronal T1-weighted MR image (150/4.2) obtained after IV administration of gadolinium shows enhancing areas of lesion (arrows) in enlarged right cornu.

 

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