As practice shows, in 19-25% of cases of tumors that occur in the genitals, an anechogenic formation in the ovary is detected. Diagnosis of a true tumor in the area of the appendages determines the appointment of an urgent examination and surgical treatment. The most common are ovarian cysts, follicular and corpus luteum.
A follicular cyst is a single-chamber fluid formation provoked by anovulation of a dominant follicle.
With a cyst of the corpus luteum, anechoic contents are detected inside the ovulated follicle.
The main methods for diagnosing cysts are ultrasound with additional Dopplerographic examination in the tumor itself and its blood flow wall, CT and MRI, bimanual examination, as well as diagnostic and treatment laparoscopy. It should be noted the importance of ultrasound in the differential diagnosis of fluid accumulations. Follicular cysts are always characterized by the presence of ovarian tissue on the periphery. Cystic diameter can be from 25 to 100 millimeters. Follicular cysts, in most cases, are single anechogenic formations with a detectable thin capsule and a characteristic uniform cluster. Behind the cyst, in all cases, the acoustic effect of increasing the signal is observed. Anechoic formations are often detected in combination with manifestations of endometrial hyperplasia.
In many cases, the disappearance of the cyst occurs spontaneously during two or three cycles of menstruation. This leads to the use of a dynamic observation method with the mandatory use of cyst echobiometry. This research tactic is due to the need for the prevention of ovarian torsion.
With a corpus luteum cyst, regression to the beginning of the next cycle of menstruation is observed. The echogram shows the location of the cyst at the back, above or on the side of the uterus. Anechoic formations can have 30-65 millimeters in diameter.
In the internal structure of the cysts of the corpus luteum, four options are divided.
The anechogenic masses are homogeneous. The second option includes homogeneous tumors with complete or incomplete single or multiple partitions having an irregular shape. The third type consists of formations with parietal structures, characterized by moderate density. Smooth or mesh structures can be 10-15 mm in diameter. The fourth type includes tumors with the identification in their structure of zones of medium echogenicity of the medium-mesh and fine-mesh structures located parietally.
On echograms, endometriotic cysts are detected in the form of roundish or moderately oval formations. Their size is 8-12 millimeters in diameter. Cysts have a smooth inner surface.
Dermoid cysts have characteristic features, manifested in the heterogeneity of their structure and in the absence of the dynamics of their ultrasound image. In the cystic cavity, structures characteristic of fat formations, bone tissue elements and hair are often visualized. At the same time, several types of teratomas are distinguished:
- completely anechoic formation with high sound conductivity, with the presence on the inner tumor surface of a small formation with high echogenicity;
- anechogenic formation with multiple small hyperechoic inclusions defined in the internal structure;
- a tumor having a dense internal structure and hyperechoic accumulation with a slightly reduced or medium sound conductivity;
- cystic-solid structure of education with the identification of a dense component with high echogenicity of oval or round shape, with clear contours;
- the formation of a completely solid structure, including two components - dense (giving an acoustic shadow) and hyperechoic;
- tumors characterized by pronounced polymorphism of the internal structure.