Diagnostic Ultrasound - Abdomen and Pelvis

Extraovarian Adnexal Mass
Lymph Nodes
Lymph Nodes
(Left) Hypoechoic enlarged
nodes can be mistaken for
cystic lesions on grayscale
ultrasound. The absence of
posterior acoustic
enhancement and presence of
internal blood flow ſt on
color Doppler confirm their
solidity. (Right) MR in the
same patient confirms the
extraperitoneal location.
Features localizing lesions to
this space include flattening
against the pelvic sidewall ſt
and loss of the fat plane with
the external iliac vessels .
Differential Diagnoses: Female Pelvis
Hematoma
Hematoma
(Left) US demonstrates a
heterogeneous, septated
adnexal mass adjacent to
the urinary bladder ſt. The
central echogenic region
represents a retracting clot.
(Right) MR in the same patient
demonstrates characteristic
dependent T2 shading ,
confirming the diagnosis of
pelvic hematoma.
Hemorrhagic corpus luteal
cyst is the likely source of
bleeding. At the periphery of
the collection is the ipsilateral
ovary ſt.
Tail Gut Cyst
Tail Gut Cyst
(Left) Oblique axial
endovaginal US shows a retrorectal
cyst containing
uniform intermediate-level
echoes representing mucinous
content. Axial section of
rectum is noted. The outer
hypoechoic rim represents the
muscularis propria layer of the
rectal wall. Note adjacent
smaller locules ſt. (Right)
Axial T1 MR in the same
patient shows a multilocular
extraperitoneal retro-rectal
cyst ſt. Contents are of T1-
intermediate signal intensity,
representing mucinous
material. Rectum st & vagina
are noted.
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