Ultrasound images: Gynecologic diagnoses (Part 1)
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.
Pedunculated fibroid
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.
Hemorrhagic cyst
Cystic mass containing a solid nodule.
Hemorrhagic cyst
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.
Ovarian cancer
Cystic mass containing an irregular solid nodule, similar to hemorrhagic cyst.
Ovarian cancer
Color Doppler flow in the center of the solid area consistent with a malignancy (pathology: endometrioid ovarian cancer).
Malignant granulosa cell tumor
Solid mass (calipers) with heterogeneous echo texture.
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.
Benign ovarian fibroma
Solid mass (calipers) shown with scant blood flows seen on color Doppler.
Torsion
Transvaginal view of the left adnexa between the uterus and left ovary, showing a whirlpool sign (arrow) of the ovarian vasculature seen on color Doppler, a reliable sign of torsion.