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Bilateral multi-loculated adnexal cystic lesions measuring 6.4 x 5.2 and 5.3 x 4 cm in maximum dimensions on the right and left sides respectively. Almost all loculae showed T2 shading reflecting hemorrhagic content. Associated with thickened uterosacral ligaments as well as stranding of the parametria bilaterally. The larger of them showed T2 dark spot sign. These cysts show no definite internal soft tissue component identified with thin hypointense walls.
This case represents multiple pelvic cysts, some of them showed high T1 signal with T2 shading suggestive of multiple endometriomas. This case also demonstrates T2 dark spot sign which is a black dot adherent to cyst wall seen in T2 images as a result of chronic hemorrhage. It helps differentiating endometrioma from a functional haemorrhagic ovarian cyst.