Diagnostic Ultrasound - Abdomen and Pelvis

Cystic Adnexal Mass
Differential Diagnoses: Female Pelvis
(Left) Longitudinal
endovaginal US shows a
typical corpus luteum as an
anechoic cyst ſt with a thick
and crenulated wall. Corpus
lutea may show variable
degrees of simple or complex
internal fluid hemorrhagic
cyst. (Right) Transverse
endovaginal US of the left
adnexa shows a thin-walled,
anechoic cyst ſt, surrounded
by free fluid, separate from
the normal follicle containing
ovary . Applying transducer
pressure in real-time can often
help in distinguishing a lesion
arising from ovary versus
broad ligament.
Corpus Luteal Cyst
Paraovarian/Paratubal Cyst
(Left) Endovaginal US shows
large simple cyst measuring 10
cm, typical of a serous
cystadenoma. A
cystadenocarcinoma would
contain mural nodules/solid
components, which would
typically be large. (Right)
Longitudinal endovaginal US
shows a cyst ſt adjacent to
the left ovary . Note the
tubular shape and longitudinal
folds st in cross section giving
the cogwheel appearance
typical of hydrosalpinx
Serous Cystadenoma
Hydrosalpinx
(Left) Endovaginal US in a 26-
year-old woman with a molar
pregnancy shows numerous
large cysts within an enlarged,
8 cm right ovary. The left
ovary was the same. Note the
difference between this and
ovarian torsion where the
cysts are small and peripheral
with central ovarian edema.
(Right) Longitudinal
endovaginal US in a woman
with prior pelvic surgery shows
large a cyst surrounding the
left ovary ſt with thin
septations st. This is typical of
a peritoneal inclusion cyst.
Theca Lutein Cysts
Peritoneal Inclusion Cysts
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