Endometrioma: with T2 dark spot sign
Young female with pelvic pain. History of cesarean section few years ago.
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Axial T1 and fat saturated T1 weighted imaging shows a diffuse hyperintense consistent with hemorrhage right cystic ovarian lesion measuring 57 x 53 x 50 mm. Axial T2WI shows relative hypointense internal shadows (T2 shading) and hypointense mural nodule within the cyst (T2 dark spot).
The case of pathologically proved endometrioma.
In mos cases distinction endometriomas from other hemorrhagic lesions, such as functional hemorrhagic ovarian cysts, can be difficult.
MR finding called the T2 dark spot sign that is specific for chronic hemorrhage and therefore is useful in the diagnosis of ovarian endometriomas.
The exact cause of this finding is unclear.
T2 dark spots may represent chronic retracted blood clots that contain a high concentration of protein and/or hemosiderin.