Question:

MRI findings of ruptured interstitial ectopic pregnancy are all of these except:
1. Eccentric location of the gestational sac on the uterine fundus.
2. Non visualization of the decidua adjacent to the chorionic sac.
3. The presence of a junctional zone between the gestational sac surrounded by myometrium and the uterine cavity.
4. The gestational sac is clearly located in a rudimentary horn with a band of tissue connecting the rudimentary horn to the uterus without an endometrial communication.
5. Myometrial defect and haemoperitoneum.





Answer:

The correct answers for the question "MRI findings of ruptured interstitial ectopic pregnancy are all of these except:" are:

2. Non visualization of the decidua adjacent to the chorionic sac.

4. The gestational sac is clearly located in a rudimentary horn with a band of tissue connecting the rudimentary horn to the uterus without an endometrial communication.



Explanation
1. Eccentric location of the gestational sac on the uterine fundus. [MRI features of advanced interstitial pregnancy include its eccentric location on the uterine fundus.].

2. Non visualization of the decidua. [Visualization of the decidua adjacent to the gestational sac is an MRI criterion for diagnosis of interstitial pregnancy.]

3. The presence of a junctional zone between the gestational sac and the endometrial cavity. [Previous case reports have suggested that the presence of a junctional zone between the gestational sac surrounded by myometrium and the uterine cavity is very suggestive of interstitial pregnancy.]

4. The gestational sac is clearly located in a rudimentary horn with a band of tissue connecting the rudimentary horn to the uterus without an endometrial communication. [This is an MRI criterion for diagnosis of pregnancy in a rudimentary horn, not an interstitial pregnancy.].

5. Myometrial defect and haemoperitoneum. [Myometrial defect and hemoperitoneum are signs of rupture.].



From the manuscript:
Ruptured Interstitial Ectopic Pregnancy at 18 Weeks Gestation Diagnosed by MRI: A Case Report
Radiology Case. 2013 Oct; 7(10):34-42


This article belongs to the OB/GYN section.




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From the manuscript

Ruptured Interstitial Ectopic Pregnancy at 18 Weeks Gestation Diagnosed by MRI: A Case Report

Free full text article: Ruptured Interstitial Ectopic Pregnancy at 18 Weeks Gestation Diagnosed by MRI: A Case Report

Abstract
Ectopic pregnancy in the interstitial part of the fallopian tube is a rare event, associated with a high rate of complications due to delayed diagnosis. Rupture of such pregnancy often results in catastrophic hemorrhage. Several reports highlighted the role of magnetic resonance imaging in establishing the diagnosis of interstitial pregnancy, but magnetic resonance imaging findings of a ruptured advanced interstitial ectopic pregnancy have not been published before. The authors therefore present characteristic findings on magnetic resonance imaging of a ruptured interstitial ectopic pregnancy which had reached 18 weeks, in a 25-year-old woman who presented with acute abdominal pain.






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