Variable MR findings in ovarian functional
hemorrhagic cysts.
MCT are sometimes difficult to distinguish on ultrasound from
hemorrhagic cysts, mucinous cystic neoplasm and endometriomas [9].
Hemorrhagic cysts 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.
Hemorrhagic cyst 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.
