Differential Diagnosis of Ovarian Endometriotic Cysts and Hemorrhagic Functional Cysts

In: MRI and CT for Decision-Making in Obstetrics and Gynecology Practice · 2025 · pp. 105–113 · doi:10.1007/978-981-97-5120-4_12 · W4409830720
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This paper questions the accuracy of MRI in differentiating between ovarian endometriotic cysts and hemorrhagic functional cysts to guide treatment decisions.

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Abstract

The 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? Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Levy 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. Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology. 1999;212:5–18. Togashi K, et al. Endometrial cysts: diagnosis with MR imaging. Radiology. 1991;180:73–8. Outwater E, et al. Characterization of hemorrhagic adnexal lesions with MR imaging: a blinded reader study. Radiology. 1993;186:489–94. Corwin 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. Cansu 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. Bulut 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. Lee 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. Potter AW, Chandrasekhar CA. US and CT evaluation of acute pelvic pain of gynecologic origin in nonpregnant premenopausal patients. Radiographics. 2008;28:1645–59. Takahashi N, et al. Usefulness of T2 star-weighted imaging in ovarian cysts and tumors. J Obstet Gynecol Res. 2016;42:1336–42. Takeuchi M, et al. Susceptibility-weighted MRI of endometrioma: preliminary results. AJR Am J Roentgenol. 2008;191:1366–70. Balaban 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. Levine 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. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Additional information This 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. Rights and permissions Copyright information © 2025 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. About this chapter Cite this chapter Nakai, 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 Download citation DOI: https://doi.org/10.1007/978-981-97-5120-4_12 Published: Publisher Name: Springer, Singapore Print ISBN: 978-981-97-5119-8 Online ISBN: 978-981-97-5120-4 eBook Packages: MedicineMedicine (R0)

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