Diagnostic Ultrasound - Abdomen and Pelvis

Hemorrhagic Cyst
(Left) Using color Doppler can
help confirm the benign
etiology of the ovarian
hemorrhagic cyst. In this color
Doppler US, theinternal
reticular echoes seen in this
hemorrhagic cyst are not
vascular. (Right) Hemorrhagic
corpus lutea (HCL) may have a
collapsed appearance, with
central hemorrhage and a
thickened, redundant wall st,
as seen on this endovaginal
grayscale US. This should not
be mistaken for an ovarian
neoplasm, as real-time
imaging will show the wall
folding inward.
Diagnoses: Female Pelvis
(Left) US in early pregnancy
shows a small intrauterine
gestational sac embedded
within the endometrium of a
retroverted uterus, with a
double decidual sac sign .
(Right) In the adnexa of the
same patient, a hemorrhagic
corpus luteum with thick wall
and peripheral blood flow is
seen on this color Doppler US.
This should not be mistaken
for the "ring of fire"
associated with tubal ectopic
pregnancies. With HCL, the
cyst is clearly within the
ovarian parenchyma.
(Left) Grayscale endovaginal
US shows a hyperacute
hemorrhagic cyst which can
appear solid, with a dense
hyperechoic component .
(Right) Color Doppler US is
helpful to confirm there is no
central vascularity, and
interval follow-up US should
be considered to demonstrate
resolution especially if > 5 cm
in diameter.
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