Ovaries

A free gallery of high-resolution, ultrasound, color doppler and 3D images

Ultrasound images of diseases of the ovary:

1) Functional cysts of the ovary:

A) Follicular cysts:

This young female patient underwent sonography for non-specific pain in the lower abdomen. Ultrasound images of the pelvis show bilateral ovarian cysts which show absence of internal nodules, septae or debris. These findings are typical of follicular cysts of the ovaries. Follicular cysts are functional cysts and are enlarged ovarian follicles that have not ruptured (ovulated). They are usually unilateral. These ultrasound images were taken using a Toshiba Nemio-XG ultrasound system.

Reference: 1) http://emedicine.medscape.com/article/255865-overview

2) http://drjoea.googlepages.com/ovary

B) Corpus Luteal cysts:

Uterus with gestation sac and embryo: Lt. adnexal cystic mass- Luteal cyst (Lt. ovary):

Rt. ovarian simple cyst:

This patient had an early gestation with embryo and intrauterine gestation sac. Sonography of the adnexal regions also showed a cystic lesion of the right ovary, which was thin walled and showed no septae or nodules within it, suggestive of a simple cyst (functional) of the right ovary. However, the left adnexal region showed a thick walled cystic lesion with echogenic walls. This appearance can easily be due to an ectopic pregnancy. Both ectopic gestations and corpus luteal cysts show similar features including the presence of "ring of fire" or ring of vessels around the lesion (on Color Doppler imaging). The left ovary was not seen separate from the left adnexal cyst; also there was no evidence of significant fluid in the cul de sac; besides, the presence of intrauterine pregnancy lead to the diagnosis of a left ovarian Corpus Luteal cyst. Ultrasound images are courtesy of Dr. V. Ganesan, MD, India.

Reference: http://emedicine.medscape.com/article/255865-diagnosis

http://www.drspock.com/article/0,1510,5335,00.html

http://www.emedicinehealth.com/ovarian_cysts/article_em.htm

2)Ovarian dermoid cyst or Cystic teratomas:

These ultrasound images reveal bilateral ovarian complex masses that contain both solid and cystic components. The right ovary shows a cystic mass with a solid, highly echogenic "dermoid plug". This is a solid nodule containing fat and various tissues including hair. Posterior acoustic shadowing is seen. The left ovary shows a dermoid plug and, in addition, a "dermoid mesh" is also seen, an irregular echogenic solid mass within the cyst. Echogenic debris is seen floating within the fluid. Images courtesy of Dr. Ravi Kadasne, UAE.

3) Endometrioma or Endometriotic cyst of ovary or Chocolate cyst of the ovary:

Case 1:

(Ultrasound image courtesy of Mr.Shlomo Gobi, Israel).

Case -2:

(Ultrasound images of chocolate cysts of ovary, courtesy of Gunjan Puri, MD, India).

Case-3:

(Sonographic images of endometrioma by Joe Antony, MD, India).

Case-4:

(Ultrasound image of endometrioma

by Joe Antony, MD, India).

Chocolate cysts or endometrioma of the ovary are caused by bleeding from ectopic endometrial tissue within the ovary. Some researchers believe that normal tissue within the ovaries might undergo changes which results in bleeding within the ovary. All the above ultrasound images (4 different cases) show small to large cystic lesions within the ovaries. The cysts show diffuse, low level echoes within them with poor flow on Doppler imaging. The main differential diagnosis in these cases is hemorrhagic cyst where fine strands are seen coursing within the cyst. Also note that endometriomas show homogenous appearance of the echogenic (altered blood) content within them. Chocolate cysts can be of varying sizes and cause considerable pain, especially during menses. Usually chocolate cysts show absence of septae or calcification and can be mistaken for solid masses. MR imaging can be helpful in clinching the diagnosis of this disease.

Reference: http://emedicine.medscape.com/article/403435-media

4) Rupture of hemorrhagic ovarian cyst:

Transabdominal scan images:

Transvaginal scan images (endovaginal imaging): Same case:

This female patient presented with pain in the pelvis and tenderness. Transabdominal sonography of the pelvis showed a large amount of free fluid with particulate matter in the cul de sac and around the right adnexal region. The right ovary showed remnants of what appeared to be a ruptured hemorrhagic corpus luteal cyst. Endovaginal imaging showed large amount of fluid with debris posterior to the uterus. The left ovary appeared normal. Lab tests and patient history excluded the possiblity of ectopic pregnancy. It was hence concluded that this was a ruptured right hemorrhagic ovarian cyst with free blood in the pelvis. The rounded echogenic mass seen near the fluid appears to be an organized blood clot. Ultrasound images are courtesy of Gunjan Puri, MD, India.

Reference: 1) http://www.jultrasoundmed.org/cgi/reprint/21/8/879 (free article and images)

2) http://www.ajronline.org/cgi/reprint/173/5/1301.pdf (free article and images)

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This page was last edited on: Wednesday March 24, 2010 02:46 PM

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