Ovarian endometrioma - T2 dark spot sign

Case contributed by Dr Ammar Haouimi

Presentation

Pelvic pain.

Patient Data

Age: 25 years
Gender: Female

A large well-defined left ovarian cystic mass (measuring 70 x 54 x 50 mm), eliciting a high signal on T1, T1 fat sat with T2 shading sign, containing a rounded nodule of a low signal on T2 sequences "T2 dark spot sign". No enhancement seen on postcontrast sequences.

Normal appearance of the uterus and right ovary.

Case Discussion

MRI features of a large right ovarian endometrioma with T2 dark spot sign.

T2 dark spot sign is specific for chronic hemorrhage and is helpful in diagnosing a solitary endometrioma from a functional hemorrhagic ovarian cyst, as both might show high T1 signal with T2 shading.

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