Presentation
Pelvic pain.
Patient Data
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 left 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.