Variable MR findings in ovarian functional hemorrhagic cysts
MCT are sometimes difficult to distinguish on ultrasound from hemorrhagic cysts
, mucinous cystic neoplasm and endometriomas .
typically are self-limiting and most resolve within two menstrual cycles.
In the first of this 4-part series on the sonographic features of cystic adnexal pathology, we focus on simple and hemorrhagic cysts
A pelvic ultrasound can help delineate the anatomic origin of the mass, but it also can detect characteristics of the mass that may help with the diagnosis, and the decision of whether or not to proceed to surgery Endometriomas, mature teratomas (dermoid cysts), simple ovarian cysts, and hemorrhagic cysts
have sonographic features that are highly predictive of the histology.
On CT, hemorrhagic cysts
may be hyperdense and can exhibit fluid-fluid levels.
A Appendicular, ovarian hemorrhagic cyst
with fullness in right thin fine septae, no fornix.
Partial differential diagnosis of adnexal cystic/ solid masses by ultrasound in the nonpregnant patient * Physiologic ovarian cyst/follicle * Other ovarian cysts * Hemorrhagic cyst
* Endometrioma * Tubo-ovarian abscess * Pyo/hydrosalpinx * Abdominal abscess * Paraovarian cyst * Dermoid cyst/Teratoma * Serous/mucinous cystadenoma or CA & other epithelium neoplasms * Fibromas/Thecomas * Ovarian mets * Ovarian torsion * Pedunculated fibroid * Peritoneal inclusion cysts Table 2.
The final pathology report determines that the hemorrhagic cyst
contained organizing clotted blood with trophoblasts, consistent with ectopic pregnancy.
or intralesional hemorrhages are confidently detected on MRI.
This system can help classify the indeterminate lesion as a benign simple or hemorrhagic cyst
, likely complex cyst requiring follow-up imaging, or possible cystic RCC that would need biopsy or excision.
The Doppler findings were normal in patients with hemorrhagic cyst
however; Doppler examination was not done in patients with complex adnexal mass and dermoid cyst.