Transabdominal and transvaginal ultrasound show a mysterious combination of two lesions in the left ovary.
So what are the findings?
There's a small, simple cyst in the affected ovary.
But in addition, there's an echogenic, ground glass appearance in the lateral aspect of the same ovary.
Diagnosis: left simple cyst with endometrioma of the same ovary. Can explain the symptoms of severe pain during menses.
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Ultrasound imaging is excellent in diagnosing this problem.
Endometriomas appear as dark, fluid-filled cysts with a "ground-glass" appearance on ultrasound.
Simple cysts appear as smooth, round, fluid-filled structures with well-defined borders.
The co-existence of an endometrioma with a simple cyst is a common finding on ultrasound and can be managed conservatively or surgically, depending on the patient's symptoms and desire for fertility.
Regular monitoring and follow-up with ultrasound can help detect changes in the size or appearance of the cysts and guide treatment decisions
On color Doppler ultrasound in this condition:
Endometriomas typically appear on gray-scale ultrasound as well-defined cystic masses with homogeneous low-level internal echoes, and often have a characteristic "ground-glass" appearance. On color Doppler ultrasound, they may show little to no vascularity, with blood flow detected only around the periphery or in septations.
Simple cysts of the ovary are usually anechoic (i.e. without internal echoes) and appear as well-defined, round, or oval cystic structures. On color Doppler ultrasound, they are typically avascular, with no detectable blood flow.
When an endometrioma and simple cyst coexist in the same ovary, the sonographic appearance can vary depending on the size and location of the cysts. On color Doppler ultrasound, the endometrioma may show low-level internal echoes, and the simple cyst may show no internal echoes, with no detectable vascularity in either structure.
In some cases, the coexistence of endometriomas and simple cysts may be associated with increased blood flow to the ovary on color Doppler ultrasound, which may suggest the presence of underlying inflammatory processes. However, this finding is not specific to endometriomas and simple cysts and requires further evaluation to determine its significance.
Color Doppler ultrasound can provide valuable information on the blood flow patterns within and around endometriomas and simple cysts, which can aid in the diagnosis and management of these conditions. However, the interpretation of color Doppler findings should always be considered in the context of the patient's clinical history, physical examination, and other imaging findings.
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