The first slideshow of our gynecologic ultrasound collection reviews commonly missed diagnoses and offers tips for recognizing them on ultrasound.
Deep infiltrating endometriosis
Transvaginal view of a loop of rectosigmoid, showing a nodular implant of endometriosis (calipers) in the muscularis of the bowel wall.
Oblique transvaginal view of the right adnexa showing a pedunculated fibroid mimicking an adnexal mass. Gentle pushing with the transducer to try to separate the mass from the uterus helped to demonstrate the peduncle (arrow). This diagnosis is further confirmed by color Doppler mapping showing the connecting vessels.
Color Doppler flow seen peripherally only in the wall of the cyst and no blood flow in the solid area, consistent with a clot in a hemorrhagic corpus luteum cyst.
Color Doppler flow in the center of the solid area consistent with a malignancy (pathology: endometrioid ovarian cancer).
Malignant granulosa cell tumor
Abundant color Doppler flow throughout the mass, consistent with a malignancy.
Benign ovarian fibroma
Solid mass (calipers) with linear vertical showing (arrows), characteristic of a fibroma.