Abstract

ABSTRACT:
BACKGROUND:
Ovarian functional hemorrhagic and endometriotic cysts are frequently seen on ultrasound examinations. Magnetic resonance imaging plays a major role in their differentiation based on different imaging characteristics.
OBJECTIVE:
Investigating magnetic resonance imaging signs to differentiate endometriotic from functional hemorrhagic cysts.
PATIENTS AND METHODS:
A prospective descriptive study of 66 cystic hemorrhagic ovarian lesions, conducted in X-ray Institute, Medical City, Bab Al-Mua’dam, Baghdad/Iraq from September 2018 to December 2019. Lesions were inspected for the presence of T2 shading, dark spot, and dark rim signs. Standard of reference was either histopathological analysis or follow-up ultrasound imaging.
RESULTS:
Of 66 hemorrhagic lesions, 39 were endometriotic cysts and 27 were functional hemorrhagic cysts. T2 dark spots were only seen in 19 of 39 endometriomas. T2 shading was seen in 34 of 39 endometriotic cysts and 8 of 27 functional hemorrhagic cysts. Twenty-four of 39 endometriotic cysts and 12 of 27 hemorrhagic cysts showed the dark rim sign.
CONCLUSION:
High sensitivity of the shading sign for diagnosing endometriomas. Identification of dark spots within endometriomas increases specificity and accuracy for their diagnosis. Dark rim sign is also useful for differentiation between endometriomas and functional hemorrhagic cysts.