Imaging

Ovarian Cyst

Preliminary Diagnosis: Ovarian Cyst

I. What imaging technique is first-line for this diagnosis?

  • Ultrasound of the pelvis: transvaginal and/or transabdominal approach

II. Describe the advantages and disadvantages of this technique for diagnosis of ovarian cyst.

Advantages

  • Does not expose patients to ionizing radiation

  • Gold standard modality in evaluating the bilateral ovaries

  • Offers exquisite detail of the arterial and venous vasculature of the ovaries

  • Highly specific in detailing the quality of the cyst and any particular complexity of the cyst

Disadvantages

  • Offers limited evaluation of the surrounding soft tissues and osseous structures

  • Highly operator dependent

III. What are the contraindications for the first-line imaging technique?

  • No specific contraindications to ultrasound exist.

IV. What alternative imaging techniques are available?

  • CT of the pelvis

  • MR of the pelvis

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of ovarian cyst.

CT of the Pelvis

Advantages

  • More sensitive and specific in evaluating the surrounding soft tissues and osseous structures than other imaging modalities

  • May evaluate for secondary ovarian complications better than other imaging modalities

Disadvantages

  • Limited in sensitivity and specificity in evaluating for ovarian torsion

  • Less sensitive and specific in detailing the ovarian structures

  • Exposes patients to ionizing radiation

MR of the Pelvis

Advantages

  • Does not expose patients to ionizing radiation

  • Offers exquisite detail of the uterus and ovarian structures

Disadvantages

  • Limited in sensitivity and specificity in evaluating for ovarian torsion

  • May be subject to motion artifact and susceptibility-weighted artifact degrading image quality.

  • Expensive

  • Time consuming

VI. What are the contraindications for the alternative imaging techniques?

CT of the Pelvis

  • May be contraindicated in pregnant patients

MR of the Pelvis

  • Contraindicated in patients with non–MR-compatible hardware

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