Hemorrhagic ovarian cyst
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Four days history of left pelvic pain
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The MRI sequences show a well-defined left ovarian ovoid cystic lesion (4.9 x 4.6 x 3.4 cm) of high signal on T1WI/T1 fat saturation and T2WI with hypointense sediment indicating blood products. The postcontrast sequences show regular peripheral enhancement.
The right ovary shows normal appearance with numerous small follicles.
Normal appearance of the uterus.
Mild effusion in Douglas pouch.
MRI findings are most consistent with a hemorrhagic ovarian cyst.
The main differential diagnosis in such cases is an ovarian endometrioma.