Presentation
Three days history of left-sided pelvic pain
Patient Data
There is a well-defined left ovarian mass of complex echotexture, predominately echogenic with fluid component, and posterior acoustic enhancement. No internal blood flow is seen on color Doppler.
The previously described mass appears well-circumscribed of centro-ovarian location of intermediate signal intensity on T1WI with areas of high signal, high signal intensity on T2WI with fluid-fluid level (the hypointense sediment indicates blood products), and hypointense wall (subacute stage with hemosiderin deposition at the wall). The postcontrast sequences show regular peripheral enhancement.
Both ovaries show numerous small follicles with minimal effusion in the Douglas pouch.
Case Discussion
Ultrasound, and MRI features of hemorrhagic ovarian cyst.
The main differential diagnosis in such cases is an ovarian endometrioma
usually contains uniform low-level internal echoes with a hypervascular wall on Doppler ultrasound
on MRI, it shows high signal on T1 and low signal on T2 (shading sign), although there is overlap in appearance with hemorrhagic cysts
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