Ovarian endometrioma - shading sign

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Chronic pelvic pain.

Patient Data

Age: 35 years
Gender: Female

The right ovary is enlarged, containing a well-defined lobulated cystic lesion (4.7 x 4.5 x 4.2 cm) of high signal on T1/T1 fat sat, T2 shading sign with double fluid-fluid levels, and thick peripheral fibrous capsule. No peripheral enhancement seen on postcontrast sequences.

Bilateral small follicles are noted.

A small Nabothian cyst otherwise normal appearance of the uterus.  ​

Case Discussion

MRI features of an ovarian endometrioma.

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