Mirror artefact on Obstetric 1st trimester transvaginal ultrasound
Ummarah Ahmad, Ma Cristina S. Borromeo, Gulsanga Afridi, Yasmin Sana
Corniche Hospital, Abu Dhabi. UAE

 

Introduction
Mirror image on ultrasound is produced when a highly reflective surface comes in the path of the primary beam. Very few cases have been reported in early pregnancy.
Case history
A 33 years old, multiparous woman with previous two vaginal deliveries presented for the viability scan. She was 7 weeks pregnant and had no clinical symptoms. The previous history included renal transplant in 2004
and type 2 diabetes.
Imaging
Transvaginal and transabdominal USS.
Initial TV USS showed findings suspicious of two uteruses with 7 weeks size viable pregnancy in each. Differential diagnosis was of mirror artefact, heterotopic pregnancy or double uterus. Further TVS for second
opinion revealed the uterine cavities appeared on either side of bladder which was seen in the middle. The second/mirror image was hypoechoic, blurred and distorted as compared to the original image
A linear echogenic foreign body was seen in the urinary bladder. Transplanted kidney was seen in the right iliac fossa. Transabdominal USS demonstrated single uterus with intrauterine pregnancy and a 3D scan
confirmed arcuate shaped uterus with pregnancy on right side. Final diagnosis was of a mirror artefact mimicking two uterus.