Hemorrhagic cysts of the ovary:
There are two types of functional cysts of the ovary: a) follicular cysts and b) corpus luteal cysts. Follicular cysts are formed by collection of fluid within non-dominant follicles in the ovary. Luteal cysts are formed by failure of absorption of the corpus luteum. Both of these cysts can have internal hemorrhage into its lumen. This results in the formation of hemorrhagic cysts of the ovary. These ultrasound images, show a large hemorrhagic cyst of the left ovary in a 17 yr. old female patient. Observe the fine reticular pattern within the cyst, suggestive of hemolysis of the clot in the cyst, a few days earlier. Other patterns that may be present, include echogenic debris. Fresh bleed would reveal an echogenic mass with posterior acoustic enhancement. A fluid- fluid level may also be present within the cyst.
Images courtesy of Dr. Ravi Kadasne, Radiologist, UAE.
Here are some images by Mr. Shlomo Gobi, Israel. You will note the presence of some degree of retraction
of the hemorrhagic contents of the cyst.
These sonographic images from my own collection show typical clot retraction within a hemorrhagic cyst:
Among the criteria to diagnose polycystic ovaries on ultrasound, the main ones are:
1) Presence of more than 10 follicles in each ovary.
2) Ovarian volume of 10 cc. or more.
3) Size of each follicle less than 10mm.
4) The follicles are arranged along the rim of the ovary producing a “string of pearls”
5) The ovarian stroma appears hyperechoic.
These ultrasound images show typical features of polycystic ovaries.
Images courtesy of Dr. Gunjan Puri, MD, Surat, India.