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IMPRESSION: There is a 4.8 cm right paraovarian structure without a definite stalk connecting it to the uterus. Differential considerations include a pedunculated uterine fibroid with a nonvisualized stalk versus a round ligament fibroid. Malignancy is felt to be less likely, but given patient history and expressed concerns, MRI of the pelvis can be considered for further evaluation. This finding and these recommendations were discussed with the patient by Dr. Rockwell at the time of exam. Arcuate uterus configuration. Follicle count: - Right ovary: 2 follicles measuring greater than 10 mm, 5 follicles measuring less than 10 mm - Left ovary: 1 follicle measuring less than 10 mm
Narrative
EXAM DESCRIPTION: US PELVIC TRANSABD/TRANSVAG COMBINATION CLINICAL HISTORY: Transvaginal pelvic ultrasound to evaluate for interval follicle count. TECHNIQUE: Transabdominal and transvaginal for better visualization uterus/ovaries. COMPARISON: None FINDINGS: UTERUS: 9.1 x 6.4 x 4.0 cm Orientation: Anteverted Appearance: Nabothian cysts. Arcuate uterus configuration. Endometrium: 0.9 cm. 1.2 cm benign-appearing endometrial polyp with a singular vascular stalk. RIGHT OVARY: 3.1 x 2.0 x 1.6 cm Appearance: Unremarkable Doppler: Blood flow in artery Follicle count: There are 2 follicles that measure greater than 10 mm and 5 follicles that measure less than 10 mm. LEFT OVARY: 3.2 x 2.6 x 1.8 cm Appearance: Unremarkable Doppler: Blood flow in artery Follicle count: There is 1 follicle that measures less than 10 mm. CUL-DE-SAC: No free fluid. OTHER: There is a 4.8 cm heterogeneous structure that slides separately from the right ovary and which may be attached to the uterine serosal surface, however no definite stalk is visible. CONCURRENT SUPERVISION: I have reviewed the images and agree with the resident/fellow's interpretation.

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