Amenorrhea ultrasound: Difference between revisions

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{{Amenorrhea}}
{{Amenorrhea}}


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==Overview==
==Overview==
There are no echocardiography/ultrasound findings associated with [disease name].
There are no [[echocardiography]] findings associated with amenorrhea. However, an [[echocardiography]] may be helpful in the [[diagnosis]] of the [[diseases]] that can cause amenorrhea, such as [[Turner syndrome]]. Findings on an [[echocardiography]] suggestive of [[Turner syndrome]] include [[bicuspid aortic valve]], elongation of [[transverse aortic arch]], [[coarctation of aorta]], and [[Partial anomalous pulmonary venous return|partial anomalous pulmonary venous return (PAPVR)]]. There are no [[ultrasound]] findings associated with amenorrhea. However, an [[ultrasound]] may be helpful in the [[diagnosis]] of the [[diseases]] that can cause amenorrhea, such as [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]], [[Premature ovarian failure|premature ovarian insufficiency]], [[androgen insensitivity syndrome]], [[17 alpha-hydroxylase deficiency|17-alpha hydroxylase deficiency]], and also anatomic [[genital]] defects.


OR
Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound  findings associated with [disease name]. However, an echocardiography/ultrasound  may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
==Echocardiography==
==Echocardiography==
*There are no echocardiography findings associated with amenorrhea. However, an echocardiography may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as Turner syndrome.
{| align="right"
*Findings on an echocardiography suggestive of Turner syndrome include:<ref name="pmid21257900">{{cite journal |vauthors=Kim HK, Gottliebson W, Hor K, Backeljauw P, Gutmark-Little I, Salisbury SR, Racadio JM, Helton-Skally K, Fleck R |title=Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population |journal=AJR Am J Roentgenol |volume=196 |issue=2 |pages=454–60 |year=2011 |pmid=21257900 |doi=10.2214/AJR.10.4973 |url=}}</ref>
|[[image:CoarctationCW.png|thumb|500px|Continuous Doppler echocardiography showing a peak systolic gradient of 69 mmHg and a low grade anterograde diastolic flow in the descending thoracic aorta (Saw Tooth), highly specific for significant aortic obstruction, before stent placement - Via WikiEcho.org<ref>WikiEcho.org. From the case <"http://www.wikiecho.org/w/images/7/77/CoarctationCW.png"></ref>]]
|}
*There are no [[echocardiography]] findings associated with amenorrhea. However, an [[echocardiography]] may be helpful in the [[diagnosis]] of the [[diseases]] that can cause amenorrhea, such as [[Turner syndrome]].
*Findings on an [[echocardiography]] suggestive of [[Turner syndrome]] include:<ref name="pmid21257900">{{cite journal |vauthors=Kim HK, Gottliebson W, Hor K, Backeljauw P, Gutmark-Little I, Salisbury SR, Racadio JM, Helton-Skally K, Fleck R |title=Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population |journal=AJR Am J Roentgenol |volume=196 |issue=2 |pages=454–60 |year=2011 |pmid=21257900 |doi=10.2214/AJR.10.4973 |url=}}</ref>
**[[Bicuspid aortic valve]] (39.2%)
**[[Bicuspid aortic valve]] (39.2%)
**Elongation of [[transverse aortic arch]] (31.4%)
**Elongation of [[transverse aortic arch]] (31.4%)
**[[Coarctation of aorta]] (15.7%)
**[[Coarctation of aorta]] (15.7%)
**[[Partial anomalous pulmonary venous return|Partial anomalous pulmonary venous return (PAPVR)]] (15.7%)
**[[Partial anomalous pulmonary venous return|Partial anomalous pulmonary venous return (PAPVR)]] (15.7%)
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==Ultrasound==
==Ultrasound==
* There are no ultrasound findings associated with amenorrhea. However, an ultrasound may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as polycystic ovary syndrome (PCOS), [[Premature ovarian failure|premature ovarian insufficiency]], androgen insensitivity syndrome, [[17 alpha-hydroxylase deficiency|17-alpha hydroxylase deficiency]], and also anatomic genital defects.
* There are no [[ultrasound]] findings associated with amenorrhea. However, an [[ultrasound]] may be helpful in the [[diagnosis]] of the [[diseases]] that can cause amenorrhea, such as [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]], [[Premature ovarian failure|premature ovarian insufficiency]], [[androgen insensitivity syndrome]], [[17 alpha-hydroxylase deficiency|17-alpha hydroxylase deficiency]], and also anatomic [[genital]] defects.


=== Polycystic ovary syndrome (PCOS) ===
=== Polycystic ovary syndrome (PCOS) ===
* Findings on an ultrasound diagnostic of [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]], Rotterdam criteria, include:<ref name="pmid14714587">{{cite journal |vauthors=Balen AH, Laven JS, Tan SL, Dewailly D |title=Ultrasound assessment of the polycystic ovary: international consensus definitions |journal=Hum. Reprod. Update |volume=9 |issue=6 |pages=505–14 |year=2003 |pmid=14714587 |doi= |url=}}</ref>
 
** Detecting 12 or more follicles measuring 2-9 mm in diameter (recently, revised as 25 or more follicles<ref name="pmid23503943">{{cite journal |vauthors=Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR |title=Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume |journal=Hum. Reprod. |volume=28 |issue=5 |pages=1361–8 |year=2013 |pmid=23503943 |doi=10.1093/humrep/det062 |url=}}</ref>)
{| align="right"
** Detecting increased ovarian volume > 10 cm3
|[[image:Polycystic-ovaries.jpg|thumb|300px|Polycystic ovary syndrome - Case courtesy of Dr J. Ray Ballinger, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/23638">rID: 23638</ref>]]
* Other findings on an ultrasound suggestive of [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] include:<ref name="pmid14714587" />
|}
** Increased stromal echogenicity  
{| align="right"
** Increased stromal volume  
|[[image:Polycystic-ovarian-syndrome.jpg|thumb|350px|Polycystic ovary syndrome, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11803">rID: 11803</ref>]]
** Peripheral location of follicles, which can give a "'''''string of pearl'''''" appearance
|}
 
* Rotterdam criteria is diagnostic of [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]]. Rotterdam criteria uses ultrasound findings which include:<ref name="pmid14714587">{{cite journal |vauthors=Balen AH, Laven JS, Tan SL, Dewailly D |title=Ultrasound assessment of the polycystic ovary: international consensus definitions |journal=Hum. Reprod. Update |volume=9 |issue=6 |pages=505–14 |year=2003 |pmid=14714587 |doi= |url=}}</ref>
** Detecting 25 or more [[Follicle|follicles]]<ref name="pmid23503943">{{cite journal |vauthors=Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR |title=Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume |journal=Hum. Reprod. |volume=28 |issue=5 |pages=1361–8 |year=2013 |pmid=23503943 |doi=10.1093/humrep/det062 |url=}}</ref>
** Detecting increased [[ovarian]] volume > 10 cm<sup>3</sup>
* Other findings on an [[ultrasound]] suggestive of [[Polycystic ovary syndrome|polycystic ovary syndrome (PCOS)]] include:<ref name="pmid14714587" />
** Increased [[stromal]] [[echogenicity]]
** Increased [[stromal]] volume  
** Peripheral location of [[Follicle|follicles]], which can give a "'''''string of pearl'''''" appearance
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=== Premature ovarian insufficiency ===
=== Premature ovarian insufficiency ===
*Findings on an ultrasound suggestive of [[Androgen insensitivity syndrome|premature ovarian insufficiency]] include:<ref name="pmid16722528">{{cite journal| author=Beck-Peccoz P, Persani L| title=Premature ovarian failure. | journal=Orphanet J Rare Dis | year= 2006 | volume= 1 | issue=  | pages= 9 | pmid=16722528 | doi=10.1186/1750-1172-1-9 | pmc=1502130 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16722528  }}</ref>
** Streak ovaries: Fibrous tissue substituted in ovaries.
** Uterus hypoplasia: Lack or shrinkage of the uterus.


*Findings on an [[ultrasound]] suggestive of [[Androgen insensitivity syndrome|premature ovarian insufficiency]] include:<ref name="pmid16722528">{{cite journal| author=Beck-Peccoz P, Persani L| title=Premature ovarian failure. | journal=Orphanet J Rare Dis | year= 2006 | volume= 1 | issue=  | pages= 9 | pmid=16722528 | doi=10.1186/1750-1172-1-9 | pmc=1502130 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16722528  }}</ref>
** Streak ovaries: [[Fibrous]] tissue substituted in [[ovaries]].
** [[Uterus]] [[hypoplasia]]: Lack or shrinkage of the [[uterus]].
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{| align="right"
| [[image:Ectopic-testes-with-torsion.jpg|thumb|350px|Androgen insensitivity syndrome, left testis in inguinal canal - Case courtesy of Dr Maulik S Patel, Via Radiopaedia.org<ref>Radiopaedia.org. From the case < "https://radiopaedia.org/cases/15786">rID: 15786</ref>]]
|}
{| align="right"
|[[image:Hydrocolpos-1.jpg|thumb|300px|Transverse vaginal septum, lead to hydrocolpos - Case courtesy of Dr G Balachandran, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5663">rID: 5663</ref>]]
|}
<br>
=== Androgen insensitivity syndrome ===
=== Androgen insensitivity syndrome ===
*Findings on an ultrasound suggestive of [[androgen insensitivity syndrome]] include:<ref name="TankKnoll2015">{{cite journal|last1=Tank|first1=Jay|last2=Knoll|first2=Abraham|last3=Gilet|first3=Anthony|last4=Kim|first4=Susanne|title=Imaging characteristics of androgen insensitivity syndrome|journal=Clinical Imaging|volume=39|issue=4|year=2015|pages=707–710|issn=08997071|doi=10.1016/j.clinimag.2015.02.002}}</ref>
 
** Bilateral cryptorchidism 
*Findings on an [[ultrasound]] suggestive of [[androgen insensitivity syndrome]] include:<ref name="TankKnoll2015">{{cite journal|last1=Tank|first1=Jay|last2=Knoll|first2=Abraham|last3=Gilet|first3=Anthony|last4=Kim|first4=Susanne|title=Imaging characteristics of androgen insensitivity syndrome|journal=Clinical Imaging|volume=39|issue=4|year=2015|pages=707–710|issn=08997071|doi=10.1016/j.clinimag.2015.02.002}}</ref>
** Juxta-testicular Mullerian duct cysts
** Bilateral [[cryptorchidism]] 
** Absent/rudimentary uterus
** Juxta or rudimentary [[uterus]]
** Shortened vagina
** Shortened [[vagina]]
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=== '''17-alpha hydroxylase deficiency''' ===
=== '''17-alpha hydroxylase deficiency''' ===
*Findings on an ultrasound suggestive of [[17 alpha-hydroxylase deficiency|17-alpha hydroxylase deficiency]] include:<ref name="pmid1561195">{{cite journal| author=Malcolm PN, Wright DJ, Edmonds CJ| title=Deficiency of 17 alpha-hydroxylase associated with absent gonads. | journal=Postgrad Med J | year= 1992 | volume= 68 | issue= 795 | pages= 59-61 | pmid=1561195 | doi= | pmc=2399301 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1561195  }}</ref>
*Findings on an [[ultrasound]] suggestive of [[17 alpha-hydroxylase deficiency|17-alpha hydroxylase deficiency]] include:<ref name="pmid1561195">{{cite journal| author=Malcolm PN, Wright DJ, Edmonds CJ| title=Deficiency of 17 alpha-hydroxylase associated with absent gonads. | journal=Postgrad Med J | year= 1992 | volume= 68 | issue= 795 | pages= 59-61 | pmid=1561195 | doi= | pmc=2399301 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1561195  }}</ref>
** Lack of gonads
** Lack of [[gonads]]
** Atrophied uterus
** Atrophied [[uterus]]
 
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<br>
{| align="right"
| [[image:Haematometrocolpos-3.jpg|thumb|300px|Hematometrocolpos, vagina filled with hematoma - Case courtesy of Dr Kewal Arunkumar Mistry, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/35073">rID: 35073</ref>]]
|}
{| align="right"
|[[image:Uterine-adhesion-band.jpg|thumb|350px|Asherman's syndrome, adhesion band in uterus cavity - Case courtesy of Dr Maulik S Patel, Via Radiopaedia.org<ref>Radiopaedia.org. From the case <"https://radiopaedia.org/cases/14540">rID: 14540</ref>]]
|}
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=== '''Anatomic genital defects''' ===
=== '''Anatomic genital defects''' ===
*Findings on an ultrasound suggestive of imperforate hymen include:<ref name="pmid21686660">{{cite journal| author=Lardenoije C, Aardenburg R, Mertens H| title=Imperforate hymen: a cause of abdominal pain in female adolescents. | journal=BMJ Case Rep | year= 2009 | volume= 2009 | issue=  | pages=  | pmid=21686660 | doi=10.1136/bcr.08.2008.0722 | pmc=3029536 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21686660  }}</ref>
 
*<ref name="Mohammed Abd Elgyoum2016">{{cite journal|last1=Mohammed Abd Elgyoum|first1=Ala|title=Case Report Diagnosing of Imperforate Hymen by Ultrasound|journal=International Journal of Biomedical Materials Research|volume=4|issue=3|year=2016|pages=27|issn=2330-7560|doi=10.11648/j.ijbmr.20160403.13}}</ref>
*Findings on an [[ultrasound]] suggestive of [[imperforate hymen]] include:<ref name="pmid21686660">{{cite journal| author=Lardenoije C, Aardenburg R, Mertens H| title=Imperforate hymen: a cause of abdominal pain in female adolescents. | journal=BMJ Case Rep | year= 2009 | volume= 2009 | issue=  | pages=  | pmid=21686660 | doi=10.1136/bcr.08.2008.0722 | pmc=3029536 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21686660  }}</ref><ref name="Mohammed Abd Elgyoum2016">{{cite journal|last1=Mohammed Abd Elgyoum|first1=Ala|title=Case Report Diagnosing of Imperforate Hymen by Ultrasound|journal=International Journal of Biomedical Materials Research|volume=4|issue=3|year=2016|pages=27|issn=2330-7560|doi=10.11648/j.ijbmr.20160403.13}}</ref>
** Hypoechoic mass in the vagina ([[hematocolpos]]) and enlarged uterus (haematometra)  
** Hypoechoic mass in the [[vagina]] ([[hematocolpos]]) and enlarged [[uterus]] ([[haematometra]])  
** Normal ovaries.
** Normal [[ovaries]]
* Findings on an ultrasound suggestive of Asherman's dyndrome include:<ref name="pmid18161399">{{cite journal |vauthors=Knopman J, Copperman AB |title=Value of 3D ultrasound in the management of suspected Asherman's syndrome |journal=J Reprod Med |volume=52 |issue=11 |pages=1016–22 |year=2007 |pmid=18161399 |doi= |url=}}</ref>
* Findings on an [[ultrasound]] suggestive of [[Asherman's syndrome]] include:<ref name="pmid18161399">{{cite journal |vauthors=Knopman J, Copperman AB |title=Value of 3D ultrasound in the management of suspected Asherman's syndrome |journal=J Reprod Med |volume=52 |issue=11 |pages=1016–22 |year=2007 |pmid=18161399 |doi= |url=}}</ref>
** Hypoechoic bands through the endometrial cavity.
** Hypoechoic bands through the [[endometrial]] cavity.
* Findings on a combined abdominal-perineal ultrasound suggestive of transverse vaginal septum include:<ref name="pmid7724147">{{cite journal |vauthors=Meyer WR, McCoy MC, Fritz MA |title=Combined abdominal-perineal sonography to assist in diagnosis of transverse vaginal septum |journal=Obstet Gynecol |volume=85 |issue=5 Pt 2 |pages=882–4 |year=1995 |pmid=7724147 |doi= |url=}}</ref>
* Findings on a combined [[abdominal]]-[[perineal]] [[ultrasound]] suggestive of transverse [[vaginal septum]] include:<ref name="pmid7724147">{{cite journal |vauthors=Meyer WR, McCoy MC, Fritz MA |title=Combined abdominal-perineal sonography to assist in diagnosis of transverse vaginal septum |journal=Obstet Gynecol |volume=85 |issue=5 Pt 2 |pages=882–4 |year=1995 |pmid=7724147 |doi= |url=}}</ref>
** '''''Abdominal ultrasound:''''' Large hourglass-shape hypoechoic abdominopelvic mass with bilateral symmetric tubular projections
** '''''Abdominal ultrasound:''''' Large hourglass-shape hypoechoic abdominopelvic mass with bilateral symmetric tubular projections
** '''''Perineal ultrasound:''''' Short depth vagina with a hyperechoic shelf (septum) beneath a large hypoechoic mass ([[hematocolpos]])
** '''''Perineal ultrasound:''''' Short depth [[vagina]] with a hyperechoic shelf ([[septum]]) beneath a large hypoechoic mass ([[hematocolpos]])


==References==
==References==
{{reflist|2}}
{{reflist|2}}
 
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[[Category:Needs content]]
[[Category:Overview complete]]
[[Category:Disease]]
[[Category:Endocrinology]]
[[Category:Gynecology]]




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Latest revision as of 20:22, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

There are no echocardiography findings associated with amenorrhea. However, an echocardiography may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as Turner syndrome. Findings on an echocardiography suggestive of Turner syndrome include bicuspid aortic valve, elongation of transverse aortic arch, coarctation of aorta, and partial anomalous pulmonary venous return (PAPVR). There are no ultrasound findings associated with amenorrhea. However, an ultrasound may be helpful in the diagnosis of the diseases that can cause amenorrhea, such as polycystic ovary syndrome (PCOS), premature ovarian insufficiency, androgen insensitivity syndrome, 17-alpha hydroxylase deficiency, and also anatomic genital defects.

Echocardiography

Continuous Doppler echocardiography showing a peak systolic gradient of 69 mmHg and a low grade anterograde diastolic flow in the descending thoracic aorta (Saw Tooth), highly specific for significant aortic obstruction, before stent placement - Via WikiEcho.org[1]













Ultrasound

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome - Case courtesy of Dr J. Ray Ballinger, Via Radiopaedia.org[3]
Polycystic ovary syndrome, Via Radiopaedia.org[4]



Premature ovarian insufficiency



Androgen insensitivity syndrome, left testis in inguinal canal - Case courtesy of Dr Maulik S Patel, Via Radiopaedia.org[8]
Transverse vaginal septum, lead to hydrocolpos - Case courtesy of Dr G Balachandran, Via Radiopaedia.org[9]


Androgen insensitivity syndrome




17-alpha hydroxylase deficiency



Hematometrocolpos, vagina filled with hematoma - Case courtesy of Dr Kewal Arunkumar Mistry, Via Radiopaedia.org[12]
Asherman's syndrome, adhesion band in uterus cavity - Case courtesy of Dr Maulik S Patel, Via Radiopaedia.org[13]


Anatomic genital defects

References

  1. ↑ WikiEcho.org. From the case <"http://www.wikiecho.org/w/images/7/77/CoarctationCW.png">
  2. ↑ Kim HK, Gottliebson W, Hor K, Backeljauw P, Gutmark-Little I, Salisbury SR, Racadio JM, Helton-Skally K, Fleck R (2011). "Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population". AJR Am J Roentgenol. 196 (2): 454–60. doi:10.2214/AJR.10.4973. PMID 21257900.
  3. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/23638">rID: 23638
  4. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/11803">rID: 11803
  5. ↑ 5.0 5.1 Balen AH, Laven JS, Tan SL, Dewailly D (2003). "Ultrasound assessment of the polycystic ovary: international consensus definitions". Hum. Reprod. Update. 9 (6): 505–14. PMID 14714587.
  6. ↑ Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR (2013). "Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume". Hum. Reprod. 28 (5): 1361–8. doi:10.1093/humrep/det062. PMID 23503943.
  7. ↑ Beck-Peccoz P, Persani L (2006). "Premature ovarian failure". Orphanet J Rare Dis. 1: 9. doi:10.1186/1750-1172-1-9. PMC 1502130. PMID 16722528.
  8. ↑ Radiopaedia.org. From the case < "https://radiopaedia.org/cases/15786">rID: 15786
  9. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/5663">rID: 5663
  10. ↑ Tank, Jay; Knoll, Abraham; Gilet, Anthony; Kim, Susanne (2015). "Imaging characteristics of androgen insensitivity syndrome". Clinical Imaging. 39 (4): 707–710. doi:10.1016/j.clinimag.2015.02.002. ISSN 0899-7071.
  11. ↑ Malcolm PN, Wright DJ, Edmonds CJ (1992). "Deficiency of 17 alpha-hydroxylase associated with absent gonads". Postgrad Med J. 68 (795): 59–61. PMC 2399301. PMID 1561195.
  12. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/35073">rID: 35073
  13. ↑ Radiopaedia.org. From the case <"https://radiopaedia.org/cases/14540">rID: 14540
  14. ↑ Lardenoije C, Aardenburg R, Mertens H (2009). "Imperforate hymen: a cause of abdominal pain in female adolescents". BMJ Case Rep. 2009. doi:10.1136/bcr.08.2008.0722. PMC 3029536. PMID 21686660.
  15. ↑ Mohammed Abd Elgyoum, Ala (2016). "Case Report Diagnosing of Imperforate Hymen by Ultrasound". International Journal of Biomedical Materials Research. 4 (3): 27. doi:10.11648/j.ijbmr.20160403.13. ISSN 2330-7560.
  16. ↑ Knopman J, Copperman AB (2007). "Value of 3D ultrasound in the management of suspected Asherman's syndrome". J Reprod Med. 52 (11): 1016–22. PMID 18161399.
  17. ↑ Meyer WR, McCoy MC, Fritz MA (1995). "Combined abdominal-perineal sonography to assist in diagnosis of transverse vaginal septum". Obstet Gynecol. 85 (5 Pt 2): 882–4. PMID 7724147.

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