The Ovarian Oddities
Fibroids & Friends
The Endo Zone
Tiny Sacs, Big Problems
Twist & Shout
100
Thin-walled, anechoic, posterior enhancement, no septations.
What is a simple ovarian cyst?
100
Well-circumscribed hypoechoic mass within myometrium.
What is a fibroid (leiomyoma)?
100
Single feeding vessel on color Doppler within echogenic intracavitary mass.
What is an endometrial polyp?
100
Adnexal mass with peripheral vascularity (“ring of fire”).
What is ectopic pregnancy?
100
Enlarged ovary with peripheral follicles.
What is ovarian torsion?
200
Lace-like internal echoes with fibrin strands.
What is a hemorrhagic cyst?
200
Fibroid projecting into the endometrial cavity.
What is a submucosal fibroid?
200
Diffuse thickened endometrium in premenopausal patient.
What is endometrial hyperplasia?
200
Fluid collection in uterus without yolk sac.
What is a pseudogestational sac?
200
Twisted vascular pedicle appearance.
What is the whirlpool sign?
300
Homogeneous low-level echoes described as “ground glass.”
What is an endometrioma?
300
Heterogeneous myometrium with myometrial cysts and indistinct junctional zone.
What is adenomyosis?
300
Postmenopausal endometrium measuring 3 mm.
What is normal?
300
First structure seen inside gestational sac confirming IUP.
What is a yolk sac?
300
Most sensitive Doppler finding in torsion.
What is absent or reduced venous flow?
400
Echogenic focus with shadowing and possible “tip of the iceberg” sign.
What is a dermoid (mature cystic teratoma)?
400
Fibroid attached by a stalk, may mimic adnexal mass.
What is a pedunculated fibroid?
400
Postmenopausal patient with bleeding. Endometrium measures 12 mm and appears irregular and heterogeneous with increased vascularity.
What is endometrial carcinoma?
400
An intrauterine gestational sac measures 28 mm mean sac diameter with no yolk sac or embryo visualized.
What is the diagnosis?
What is an anembryonic pregnancy (failed early pregnancy)?
400
Why does arterial flow sometimes remain in torsion?
Dual blood supply and intermittent torsion.
500
A cyst has internal echoes and septations but strong posterior enhancement. What Doppler feature helps differentiate hemorrhagic cyst from neoplasm?
What is absence of internal vascular flow in hemorrhagic cyst.
500
Shadowing uterus with globular enlargement but no discrete mass.
What is adenomyosis (not fibroids)?
500
Premenopausal patient, day 24 of cycle, endometrium measures 14 mm and appears homogeneous.
Is this abnormal?
What is secretory phase endometrium (normal finding)?
500
An adnexal mass demonstrates a “ring of fire” on color Doppler. The patient is stable, and an intrauterine pregnancy is confirmed.
What is the most likely diagnosis?
What is a corpus luteum cyst?
500
A patient presents with pelvic pain and fever. Ultrasound shows a complex multiloculated adnexal mass with thick walls and marked peripheral hyperemia on Doppler. The ovary is difficult to distinguish from the mass.
What is the most likely diagnosis?
What is a tubo-ovarian abscess?