Endometrioma: with T2 dark spot sign

Case contributed by Dr Ayaz Hidayatov

Presentation

Young female with pelvic pain. History of cesarean section few years ago.

Patient Data

Age: 26
Gender: Female

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).

Case Discussion

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.

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Case information

rID: 52368
Case created: 4th Apr 2017
Last edited: 3rd Jun 2017
System: Gynaecology
Inclusion in quiz mode: Included

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