Focal hyperdense areas in endometriomas: a characteristic finding on CT
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CT scans showing a hyperdense focus within an ovarian cyst, correlating with a blood clot, were 15% sensitive and 100% specific for identifying endometriomas.
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Abstract
OBJECTIVE: To assess the value of a hyperdense focus seen on CT scans of endometrial cysts in the differential diagnosis of a lesion.
MATERIALS AND METHODS: The preoperative CT scans of 328 patients with 410 ovarian masses (54 patients with 62 pathologically proved endometriomas and 274 patients with 348 pathologically proved other ovarian masses) were retrospectively reviewed in a random fashion without knowledge of the pathologic findings to determine whether a hyperdense focus was visible inside a cyst.
RESULTS: In nine of 62 endometrial cysts (sensitivity, 15%), CT scans showed a hyperdense round or crescent-shaped focus, measuring 2 to 15 mm. This focus was located close to the inner border of the cyst in eight cases and in the central part of the cyst in one case. A hyperdense focus was not seen on CT scans of 348 other ovarian masses (specificity, 100%). An in vitro CT study of two specimens showed that this hyperdense area corresponded to a blood clot next to the inner wall of the cyst. This hyperdense area appeared as a nonspecific hyperechogenic focus on sonograms in five of nine cases and as a hypointense signal on T1- and/or T2-weighted MR images in four of five cases.
CONCLUSION: The finding on CT scans of a hyperdense focus inside an ovarian cyst is suggestive of endometrioma and should help distinguish endometrioma from other pelvic masses.
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Cited by (19)
- Endometrioma: A Comprehensive Review of Its Varied Presentations, Complications, and Impact on Patient Management 2025
- Giant ovarian endometrioma presenting as intestinal obstruction 2023
- Giant Ovarian Endometrioma: A Case Report 2021
- Endometriosis revisited: an imaging review of the usual and unusual manifestations with pathological correlation 2018
- Factors that Differentiate between Endometriosis-associated Ovarian Cancer and Benign Ovarian Endometriosis with Mural Nodules 2017
- Massive endometrioma presenting with dyspnea and abdominal symptoms 2017
- Pelvic Inflammatory Disease: Multimodality Imaging Approach with Clinical-Pathologic Correlation 2016
- Endometrioma: Computed Tomography and Magnetic Resonance Imaging 2013
- Secondary Mullerian System 2013
- Proteinase-activated receptors in the endometrium and endometriosis 2012
- CT imaging findings of ruptured ovarian endometriotic cysts: emphasis on the differential diagnosis with ruptured ovarian functional cysts 2011
- Unusual manifestations and complications of endometriosis--spectrum of imaging findings: pictorial review 2010
- Endometriosis 2008
- Imaging in endometriosis 2007
- An evidence-based evaluation of endometriosis-associated infertility 2003
- Imaging in endometriosis 2003
- Gynecologic Causes of Acute Pelvic Pain: Spectrum of CT 2002
- Treatment of Ovarian Endometriosis 1995
- THE OVARY 1993
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