Presentation
Pelvic pain
Patient Data
Ultrasound images reveal a low-level, homogeneous, unilocular cyst with "ground-glass" internal echoes on the left adnexa.
The imaging results show the presence of a well-defined cystic mass in the left ovary. The mass appears as a mixture of low and high signals on T1 with T2 shading sign. Additionally, there are peripheral nodules that present a low signal on T2 sequences, which is referred to as the "T2 dark spot" sign. On postcontrast sequences, only smooth wall enhancement was observed.
Normal appearance of the uterus and right ovary.
Case Discussion
This case shows left ovarian endometrioma with the characteristic T2 shading sign and T2 dark spot sign.
T2 dark spot sign is characteristic of chronic hemorrhage and is helpful in distinguishing a solitary endometrioma from a hemorrhagic ovarian cyst, as both may display high T1 signal with T2 shading.
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