Diagnostic ultrasound ( PDFDrive )

1876 PART V Pediatric Sonography
RT
LT
B
A
B
FIG. 54.9 Ovarian Cysts in Newborn Girl. (A) Right ovary. (B) Left ovary. Cysts manifested as a lower abdominopelvic mass. Multiple anechoic
cystic areas with septations are noted in ovaries bilaterally (arrows). Ovarian cysts were believed to be secondary to in utero hormonal stimulation.
Follow-up studies (not shown) showed complete regression. B, Bladder.
Ovarian
cyst
Paraovarian
cyst
Ovarian
cyst
A
RT Ovary Sag
RT Adnexa Sag
FIG. 54.10 Adnexal Cysts in Teenager. (A) and (B) Sonograms demonstrate a simple cyst within the right ovary. In addition, a simple parovarian
cyst is demonstrated in (B).
B
vascular structures on color Doppler sonography (“whirlpool
sign”). he absence of low on color Doppler ultrasound is not
a reliable diagnostic criterion because peripheral (or even central)
arterial low can be seen in surgically proven twisted ovaries.
his may be explained by the duality of the ovarian arterial
perfusion. 28 he demonstration of multiple follicles (8-12 mm
in size) in the cortical or peripheral portion of a unilaterally
enlarged ovary has been reported as a speciic sonographic sign
of torsion. 29-31 hese cystic changes occur in up to 74% of twisted
ovaries and are attributed to transudation of luid into follicles
secondary to vascular congestion. At times, isolated fallopian
tube torsion occurs in perimenarcheal girls with acute pelvic
pain and in whom a cystic mass in a midline position is
demonstrated (either in the cul-de-sac or superior to the uterus)
in association with a normal ipsilateral ovary. 32
Acute Ovarian Torsion: Sonographic Findings
Ovarian enlargement
Fluid in cul-de-sac
Adnexal mass (ovarian hemorrhage or infarction)
Cystic or complex
Fluid-debris level
Multiple peripheral follicles
“Whirlpool sign” on color Doppler