{"paper_id":"271a0f6a-8b14-4e94-9005-75e9278fc80e","body_text":"Abstract\nThe patient, a woman in her 40s under fertility treatment, was referred for a myomectomy. A pelvic MRI scan showed a 4 cm hemorrhagic cyst in her right ovary (Fig. 12.1). The treatment plan hinges on the nature of this cyst. If it is an ovarian endometriotic cyst, we plan to schedule an ovarian cystectomy alongside the myomectomy. However, if it is merely a hemorrhagic functional cyst, we will forego the ovarian cystectomy. The key question is: Is the accuracy of the MRI in differentiating between these two types of cysts?\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nLevy BS, et al. Endometriosis: Management of ovarian endometriomas. In: Post TW, editor. UpToDate. Waltham, MA: UpToDate [cited 2019 Mar 10]. https://www.uptodate.com/contents/endometriosis-management-of-ovarian-endometriomas.\nSiegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology. 1999;212:5–18.\nTogashi K, et al. Endometrial cysts: diagnosis with MR imaging. Radiology. 1991;180:73–8.\nOutwater E, et al. Characterization of hemorrhagic adnexal lesions with MR imaging: a blinded reader study. Radiology. 1993;186:489–94.\nCorwin MT, et al. Differentiation of ovarian endometriomas from hemorrhagic cysts at MR imaging: utility of the T2 dark spot sign. Radiology. 2014;271:126–32.\nCansu A, et al. Diagnostic efficacy of T2 dark spot, T2 dark rim signs, and T2 shading on magnetic resonance imaging in differentiating endometriomas from hemorrhagic cysts. J Comput Assist Tomogr. 2019;43:619–22.\nBulut M, et al. The efficiency of susceptibility-weighted MRI in the differentiation of endometriomas from haemorrhagic ovarian cysts. Abdom Radiol (NY). 2021;46:5337–43.\nLee NK, et al. Diffusion-weighted magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts in the ovary. Acta Radiol. 2016;57:998–1005.\nPotter AW, Chandrasekhar CA. US and CT evaluation of acute pelvic pain of gynecologic origin in nonpregnant premenopausal patients. Radiographics. 2008;28:1645–59.\nTakahashi N, et al. Usefulness of T2 star-weighted imaging in ovarian cysts and tumors. J Obstet Gynecol Res. 2016;42:1336–42.\nTakeuchi M, et al. Susceptibility-weighted MRI of endometrioma: preliminary results. AJR Am J Roentgenol. 2008;191:1366–70.\nBalaban M, et al. The utility of diffusion-weighted magnetic resonance imaging in differentiation of endometriomas from hemorrhagic ovarian cysts. Clin Imaging. 2015;39:830–3.\nLevine D, et al. Management of asymptomatic ovarian and other adnexal cysts imaged at the US Society of Radiologists in Ultrasound consensus conference. Ultrasound Q. 2010;26:121–31.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nAdditional information\nThis chapter serves as a tribute to the cherished memory of my esteemed co-author and beloved mentor, Eriko Maeda. A beacon of guidance in both academia and my personal life, she approached the pursuit of knowledge with boundless passion and unwavering dedication.\nRights and permissions\nCopyright information\n© 2025 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.\nAbout this chapter\nCite this chapter\nNakai, Y., Maeda, E. (2025). Differential Diagnosis of Ovarian Endometriotic Cysts and Hemorrhagic Functional Cysts. In: Matsumura, N., Matsuki, M., Kido, A. (eds) MRI and CT for Decision-Making in Obstetrics and Gynecology Practice. Springer, Singapore. https://doi.org/10.1007/978-981-97-5120-4_12\nDownload citation\nDOI: https://doi.org/10.1007/978-981-97-5120-4_12\nPublished:\nPublisher Name: Springer, Singapore\nPrint ISBN: 978-981-97-5119-8\nOnline ISBN: 978-981-97-5120-4\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}