Lesson 6 (Part 2) Flashcards
What is the sonographic appearance of a follicular cyst? (4)
- Anechoic
- Thin walled
- Posterior enhancement
- Measures equal or > 3cm
What is a follicular cyst also known as?
A simple cyst
Is a follicular cyst larger or smaller than a follicle?
Larger
Are follicular cysts usually unilateral or bilateral?
Unilateral
Are follicular cysts symptomatic or asymptomatic?
Asymptomatic
How are follicular cysts found on US?
Frequently incidentally
How do you resolve a follicular cysts?
On its own
- this is why most radiologists/Gyn do not choose to follow up if it is not 3cm or greater especially if its an asymptomatic patient
How do you get a corpus luteal cyst?
After ovulation Failure of absorption or excessive bleeding into corpus luteum
How large is a corpus luteal cyst?
4-5cm
What is more common follicular cysts of corpus luteal cysts?
Follicular cysts
What is more symptomatic follicular cysts of corpus luteal cysts?
Corpus luteal cysts
Are corpus luteal cysts unilateral or bilateral?
Unilateral
What are corpus luteal cysts more prone to? (2)
- Rupture
2. Hemorrhage
What is a major symptom of corpus luteal cysts?
Pain
What is a differential diagnosis for corpus luteal cysts?
Ectopic pregnancy
- if positive B-HCG and no intrauterine pregnancy seen
What is the sonographic appearance of corpus luteum? (7)
- Small
- < 4cm - Hypoechoic or isoechoic
- Cyst with low-level internal echoes
- Usually thicker walls than a follicle
- Crenulated appearance
- fine edge - Peripheral rim of colour
- ring of fire - Involutes before menstruation
What is the sonographic appearance of corpus luteal cysts? (2)
- > 4cm
2. If hemorrhage differing US appearances due to variable appearance of blood
What is the largest of the functional ovarian cysts?
The theca luteal cysts
What are theca luteal cysts associated with?
High levels of hCG
Where do theca luteal cysts mostly occur? (2)
- Gestational trophoblastic disease
- Ovarian Hyperstimulation Syndrome
- fertility complication
Are theca luteal cysts unilateral or bilateral?
Bilateral
What is the sonographic appearance of theca luteal cysts? (3)
- Bilateral
- Multilocular
- looks like lots of different follicles within - Large
What are 4 complications for functional cysts?
- Hemorrhage
- Enlargement
- Rupture
- Torsion
What is a symptom from complications from functional cysts?
Acute pain
What can occur in functional cysts?
Internal haemorrhage
What is the most common corpus luteal cysts?
Hemorrhagic cysts
What is the fundamental characteristic of a cyst?
Posterior enhancement
How can we tell the difference between a follicular or corpus luteal cyst undergoing hemorrhage?
We cant
What is a symptom of hemorrhagic cysts?
Acute onset of pelvic pain
What is the appearance of an Acute Hemorrhagic Cyst? (5)
- Hyper echoic
- May mimic a solid mass
- Smooth posterior wall
- Posterior acoustic enhancement
- Reticular
- strands of blood
Why are there so many different sonographic appearances of hemorrhagic cysts?
Appearance is based on the stage of clotting and blood changes as it ages
- anechoic (new blood)—> reticular pattern —> hyper echoic —> can come back to anechoic
Does Colour Doppler help with diagnosis of a hemorrhagic cyst?
Yes
- will show peripheral vascularity within the wall
- clot can move and show colour
- a cyst shouldn’t have an internal vascularity
What could free fluid in the pelvis indicate?
Leaking or ruptures hemorrhagic cyst
What are the differential diagnosis for a hemorrhagic cyst? (3)
- Ruptured ectopic pregnancy
- Corpus luteal
- Endometrioma
