Diagnostic Ultrasound - Abdomen and Pelvis

Ovarian Hyperstimulation Syndrome
(Left) Closer evaluation with
grayscale US of a
hyperstimulated ovary shows
a "spoke-wheel" appearance
due to the central area of
stromal tissue st with
enlarged peripheral follicles.
(Right) In some cases, the
enlarged follicles can have
reticular echogenicities on
grayscale US, indicating
internal hemorrhage ſt. Note
the follicles are separated by
thin septa , as opposed to
the thick papillary projections
typically seen in ovarian
neoplasm.
Diagnoses: Female Pelvis
(Left) In late OHSS, there is
typically an implanted
pregnancy st (calipers mark
the uterus) as seen in this
patient on a transabdominal
US longitudinal view of the
pelvis. (Right) Anechoic fluid
at the inferior margin of the
liver on grayscale US reflects
increased permeability of the
peritoneal surfaces with
leakage of fluid out of the
intravascular space in this
patient with OHSS.
(Left) In this case,
transabdominal US shows the
uterus surrounded by bilateral
adnexal "masses" st (labeled
RO and LO), which are the
enlarged hyperstimulated
ovaries. (Right) At times the
enlarged ovaries appear solid
if there are multiple
hemorrhagic follicles (ovaries
labeled RO and LO). Often the
ovaries can be found in close
approximation at the midline
pelvis as seen on grayscale US
in this patient with
hyperstimulated ovaries.
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