Ovarian dermoid cyst - MRI
Irregular menstrual periods.
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There is a 9 x 10 cm large multiloculated complex cystic mass in right adnexa with internal Rokitansky nodule and small fat nodule at the most anterior part which show signal drop on fat-suppressed sequence highly suggestive for a dermoid cyst.
Stretching of the uterus posteriorly also is noted.
The left ovary is normal in shape and signal intensity without evidence of solid or cystic mass lesions.
Fat suppression sequences are used to differentiate between the ovarian dermoid cyst and hemorrhagic/endometrioma cyst as dermoid cyst contains fat and its signal will be suppressed in fat suppression.
In the recent case, the complex cystic mass show T2 shading similar to endometrioma, but the presence of the Rokitansky nodule and small fat component at the anterior part of the mass are diagnostic clues for the dermoid cyst.