Diagnostic Ultrasound - Abdomen and Pelvis

Extraovarian Adnexal Mass
Differential Diagnoses: Female Pelvis
(Left) Sagittal MR in the same
patient demonstrates a welldemarcated,
ovoid, retrouterine
mass with
heterogeneous internal signal.
Note feeding vessels ſt.
(Right) MR clearly depicts the
pedicle between the retrouterine
mass and the
myometrium, with multiple
internal low signal serpiginous
feeding vessels that were
visible sonographically. The
ovaries are seen separately
ſt.
Subserosal Leiomyoma/Broad Ligament
Fibroid
Subserosal Leiomyoma/Broad Ligament
Fibroid
(Left) The interconnecting
nature of the C- or S-shaped
tubular cystic structures seen
here is readily
demonstrated by real-time
ultrasound. The anechoic
nature of the internal fluid is
consistent with hydrosalpinx
(Right) T2-weighted MR shows
incomplete internal septations
representing the folds in the
walls of fallopian tube ſt.
Note internal T2 shading in
the dependent/widest part of
the dilated tube. Appearances
are compatible with
hematosalpinx. Adjacent
Infiltrative endometriosis is
seen.
Hydrosalpinx/Hematosalpinx/Pyosalpinx
Hydrosalpinx/Hematosalpinx/Pyosalpinx
(Left) The normal ovary is
suspended in the center of a
fluid-filled cavity by band-like
adhesions . Appearances
represent a peritoneal
inclusion cyst. (Right) Axial
T2WI MR in the same patient
demonstrates the conformal
nature of the fluid to the
pelvic peritoneal contours,
confirming the diagnosis. The
left ovary is again seen
suspended within the fluid by
bands of septations (spider
web sign).
Peritoneal Inclusion Cyst
Peritoneal Inclusion Cyst
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