Utility of “T2 Dark Spot” Sign In The Diagnosis of Endometriomas: A Literature Review

Abdomen, Genital / Reproductive system female, Pelvis, MR, Statistics, Cysts Authors: S. Siddiqui, Z. Siddiqui DOI: 10.26044/ecr2025/C-21979 Learning objectives To assess the utility of “T2 Dark Spot” Sign seen on MR imaging in the diagnosis of Endometriomas.

MR imaging plays an important role in the diagnosis of endometriomas as it reveals various features that aid in its diagnosis. However, some imaging features of endometriomas may overlap with findings in other hemorrhagic adnexal masses, raisingan occasional diagnostic challenge. The “T2 dark spot” is a finding on MR imaging that has been described to be specific for Endometriomas. This sign thus aids in differentiation of endometriomas from other adnexal masses,namely hemorrhagic cysts.We aim to conduct a literature review assessing the sensitivity and specificity of... Findings and procedure details The “T2 dark spot” is a finding on MR imaging that has been described to be specific for Endometriomas. It refers to curvilinear, punctate, or focal hypointense foci on T2-weighted images that are adjacent to the wall of the endometriotic cysts. The exact cause of this finding is unclear, however, the authors speculate that the T2 dark spots likely represents chronic retracted blood clots that contain a high concentration of protein and/or hemosiderin.Three studies were included based on the inclusion criteria. All studies demonstrated high...

The T2 dark spot sign demonstrates high specificity making it a useful sign in the diagnosis of Endometriomas. The sign however suffers comparatively lower sensitivity in a few studies, therefore the absence of T2 dark spot sign does not exclude the diagnosis of endometriosis. The sign can also be used, when present, to help differentiate endometriotic cysts from hemorrhagic cysts. Personal information and conflict of interest S. Siddiqui: Nothing to disclose Z. Siddiqui: Nothing to disclose

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