Ovarian endometriomas (kissing ovaries sign)
Citation, DOI & case data
Chronic pelvic pain.
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The right ovary shows unilocular cysts (largest measures 5.4 x 4.3 x 4 cm), as well as a small cystic lesion (2.5 x 2.2 x 1 cm) of high signal on T1/T1 fat, sat, low signal on T2 with no enhancement on postcontrast sequences in keeping with endometrioma.
The left ovary shows also a cystic lesion (4.8 x 4 x 35 cm) of high signal on T1/T1 fat sat, low signal on T2 with no enhancement on postcontrast sequences in keeping with endometrioma.
Normal appearance of the uterus.
The kissing ovaries sign is most frequently seen in the severe form of pelvic endometriosis, The repeated bleeding causes adhesions with pulling off the ovaries toward the midline. It may be seen in pelvic inflammatory disease such as pyosalpinx and pelvic abscess.