▪︎Hemorrhage cyst:
•Three Patterns:
1- Reticular pattern(Lacy, weblike): Fibrin strand multiple enumerable discontinues.
2- Fluid level ē dependant echogenic material.
3- Clot retraction.
•No internal vascularity.
•Ring of fire sign: surrounding ring of vascularity.
•Follow up: Resolved or at least temporary change.
☆ If less than 3cm don't mention it in report but in our contrary mention it.
☆ If large cyst that can't be viewed in one view in ultrasound,consider CT or MRI to see entire cyst to exclude any thing like mural nodule that made it cystic neoplasm.
☆ In female pelvic ultrasound when you found cystic lesion, you must be identifie the bladder first to avoiding mistakes.
#Gynecology #US
Ultrasonographic Findings:•Three Patterns:
1- Reticular pattern(Lacy, weblike): Fibrin strand multiple enumerable discontinues.
2- Fluid level ē dependant echogenic material.
3- Clot retraction.
•No internal vascularity.
•Ring of fire sign: surrounding ring of vascularity.
•Follow up: Resolved or at least temporary change.
☆ If less than 3cm don't mention it in report but in our contrary mention it.
☆ If large cyst that can't be viewed in one view in ultrasound,consider CT or MRI to see entire cyst to exclude any thing like mural nodule that made it cystic neoplasm.
☆ In female pelvic ultrasound when you found cystic lesion, you must be identifie the bladder first to avoiding mistakes.
#Gynecology #US
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▪︎ Endometrioma (chocolate cyst):
(The only difference between the simple cyst and endometrioma is that the cyst in simple cyst is anechoic but in endometrioma is homogeneous gray pattern (ground glass appearance)
- Hypoechoic (gray color).
- Internal echoes.
- Clot retraction.
- Fluid level.
- Echogenic foci in peripheral ē comt tail artifact(Pathognomic).
☆ 25% Bilateral
☆ 1-2% risk of malignancy.
#Gynecology #US
(The only difference between the simple cyst and endometrioma is that the cyst in simple cyst is anechoic but in endometrioma is homogeneous gray pattern (ground glass appearance)
Ultrasonographic Findings:- Hypoechoic (gray color).
- Internal echoes.
- Clot retraction.
- Fluid level.
- Echogenic foci in peripheral ē comt tail artifact(Pathognomic).
☆ 25% Bilateral
☆ 1-2% risk of malignancy.
#Gynecology #US
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▪︎ Pertioneal inclusion cyst:
(A large, irregular or ovoid, echolucent cyst with fine internal septations surrounds a normal-appearing ovary. The ovary is often in the center of the inclusion cyst give spider in web appearance)
- Unilocular or multilocular pelvic cystic structure ē internal echoes.
- Boundaries defined by pelvic structures.
- Normal ovary surrounded or displaced by fluid and septations.
- Septations connect to ovary.
- Fine septations most common.
- Thick septations with nodules possible.
- Entrapped ovary: "Spider in web" appearance.
- Cogwheel sign: nodular mesothelial tissue can project within the lumen, creating a classic cogwheel appearance
☆ Hx of surgery, or PID.
☆ Developing of PIC is due to pertioneal adhesion ē exudative ovary.
#Gynecology #US
(A large, irregular or ovoid, echolucent cyst with fine internal septations surrounds a normal-appearing ovary. The ovary is often in the center of the inclusion cyst give spider in web appearance)
Ultrasonographic Findings:- Unilocular or multilocular pelvic cystic structure ē internal echoes.
- Boundaries defined by pelvic structures.
- Normal ovary surrounded or displaced by fluid and septations.
- Septations connect to ovary.
- Fine septations most common.
- Thick septations with nodules possible.
- Entrapped ovary: "Spider in web" appearance.
- Cogwheel sign: nodular mesothelial tissue can project within the lumen, creating a classic cogwheel appearance
☆ Hx of surgery, or PID.
☆ Developing of PIC is due to pertioneal adhesion ē exudative ovary.
#Gynecology #US
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▪︎Polycystic Ovary (PCO):
- Enlarged ovary volume >10ml
- Multiple peripheral follicles (string-of-pearls appearance).
- Equal or more than 20 in number.
- Each follicle <10mm.
- Echogenic center of ovary.
▪︎Rotterdam criteria of PCOS (2018):
At least tow of the following:
- Oligoovulation and/or anovulation
- Hyperandrogenism(clinical features or lab)
- Enlarged and/or polycystic ovary on US:
• Ovarian volume ≥ 10 mL
• AND/OR the presence of multiple cystic follicles measuring 2–9 mm in one or both.
• Number of follicles equal or > 20.
#Gynecology #US
Ultrasonographic Findings:- Enlarged ovary volume >10ml
- Multiple peripheral follicles (string-of-pearls appearance).
- Equal or more than 20 in number.
- Each follicle <10mm.
- Echogenic center of ovary.
▪︎Rotterdam criteria of PCOS (2018):
At least tow of the following:
- Oligoovulation and/or anovulation
- Hyperandrogenism(clinical features or lab)
- Enlarged and/or polycystic ovary on US:
• Ovarian volume ≥ 10 mL
• AND/OR the presence of multiple cystic follicles measuring 2–9 mm in one or both.
• Number of follicles equal or > 20.
#Gynecology #US
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◽️Ovarian torsion:
( Hypoechoic heterogeneous echotexture ovary ē peripheral displaced follicles, congestion, increased echogenicity of stromal tissue, and thickened fat adjacent to ovary).
▪︎Nonspecific sign:
- Enlarged ovary.
- Abnormal located.
- Hypoechoic heterogeneous echotexture.
- Ovarian cyst/lesion (⇧ incidence of torsion).
- Periovarian fluid collection (87%).
- Peripheral displaced follicles.
▪︎Specific signs(clue signs):
- Abnormal Doppler (No vascularity).
- Whirlpool sign of pedicle (twisted pedicle).
- Follicular ring sign: ⇧ echogenicity of follicles margins.
☆ Torsion can occur in any age.
☆ If we found hypervascularized in color doppler, it will be ovaritis or de-torsion.
☆ Dermoid has more chance to do torsion than endometrioma because in endometrioma there's adhesion to surrounding structures.
☆ Most common lesion lead to torsion is dermoid, hemorrhagic cyst, and cystic neoplasm, when their size is more than 5cm.
#Gynecology #US
( Hypoechoic heterogeneous echotexture ovary ē peripheral displaced follicles, congestion, increased echogenicity of stromal tissue, and thickened fat adjacent to ovary).
Ultrasonographic Findings:▪︎Nonspecific sign:
- Enlarged ovary.
- Abnormal located.
- Hypoechoic heterogeneous echotexture.
- Ovarian cyst/lesion (⇧ incidence of torsion).
- Periovarian fluid collection (87%).
- Peripheral displaced follicles.
▪︎Specific signs(clue signs):
- Abnormal Doppler (No vascularity).
- Whirlpool sign of pedicle (twisted pedicle).
- Follicular ring sign: ⇧ echogenicity of follicles margins.
☆ Torsion can occur in any age.
☆ If we found hypervascularized in color doppler, it will be ovaritis or de-torsion.
☆ Dermoid has more chance to do torsion than endometrioma because in endometrioma there's adhesion to surrounding structures.
☆ Most common lesion lead to torsion is dermoid, hemorrhagic cyst, and cystic neoplasm, when their size is more than 5cm.
#Gynecology #US
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▪︎Paraovarian cyst:
- Location:near the ovary,but separate from it.
- Shape: Round or oval.
- Margins: Thin and well-defined.
- Internal echoes: Usually anechoic (fluid-filled) or may contain few internal echoes.
- Mobility: Moves independently of the ovary when pressure is applied with the transducer.
-Simple cyst.
☆ It's hormonally unresponsive, so it's not resolve ē follow-up.
#Gynecology #US
- Location:near the ovary,but separate from it.
- Shape: Round or oval.
- Margins: Thin and well-defined.
- Internal echoes: Usually anechoic (fluid-filled) or may contain few internal echoes.
- Mobility: Moves independently of the ovary when pressure is applied with the transducer.
-Simple cyst.
☆ It's hormonally unresponsive, so it's not resolve ē follow-up.
#Gynecology #US
▪︎Benign jugular phlebectasia:
- Anechoic or hypoechoic: The vein appears filled with fluid and shows little to no internal echoes, similar to an anechoic structure or with slightly more internal echoes (hypoechoic) compared to surrounding tissue.
- Increased compressibility: The vein collapses easily when pressure is applied with the ultrasound transducer.
Hx:
- In children.
- Intermittent neck swelling.
- Not prominent during rest.
- ⇧ ē Valsalva maneuver: show significant enlargement of the internal jugular vein..
☆Mostly Resolved in age 7 year.
#Small_Part #US
- Anechoic or hypoechoic: The vein appears filled with fluid and shows little to no internal echoes, similar to an anechoic structure or with slightly more internal echoes (hypoechoic) compared to surrounding tissue.
- Increased compressibility: The vein collapses easily when pressure is applied with the ultrasound transducer.
Hx:
- In children.
- Intermittent neck swelling.
- Not prominent during rest.
- ⇧ ē Valsalva maneuver: show significant enlargement of the internal jugular vein..
☆Mostly Resolved in age 7 year.
#Small_Part #US
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