Struma ovarii echocardiography/ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Overview

Ultrasound may be helpful in the diagnosis of struma ovarii. Findings on an ultrasound are suggestive of struma ovarii occurred more frequently (68.8%) in the right adnexa and was seen with a normal CA-125 level.

Ultrasound

• Ultrasound may be helpful in the diagnosis of struma ovarii. Findings on an ultrasound are suggestive of struma ovarii occurred more frequently (68.8%) in the right adnexa and was seen with a normal CA-125 level.
• Doppler sonography flow study can help in the preoperative diagnosis of struma ovarii. In struma ovarii the blood flow signals are detected from the center of the echoic lesion.

Findings on an ultrasound suggestive of struma ovarii include:

• Transvaginal ultrasound shows solid and cystic components of the ovary and also calcifications.

• Abdomen ultrasound image helps demonstrate solid and cystic portions arising from the ovary.

(a) Transvaginal US image shows a complex mass arising from the left ovary with solid and cystic components (b) Color Doppler examination of the same mass demonstrates high vascularity in the solid portion of the left ovarian mass. CC-BY-SA, Alvarez DM, Lee V, Bhatt S, Dogra VS. Struma Ovarii with Papillary Thyroid Carcinoma. Journal of Clinical Imaging Science. 2011;1:44. doi:10.4103/2156-7514.84322.

(a) Transvaginal US image shows a complex mass with solid and cystic components and calcifications (arrow). (b) Corresponding color flow Doppler image of the lesion. CC-BY-SA, Alvarez DM, Lee V, Bhatt S, Dogra VS. Struma Ovarii with Papillary Thyroid Carcinoma. Journal of Clinical Imaging Science. 2011;1:44. doi:10.4103/2156-7514.84322.

Transabdomen grayscale US image shows a heterogeneous lesion demonstrating solid and cystic portions arising from the left ovary. CC-BY-SA, Alvarez DM, Lee V, Bhatt S, Dogra VS. Struma Ovarii with Papillary Thyroid Carcinoma. Journal of Clinical Imaging Science. 2011;1:44. doi:10.4103/2156-7514.84322.

(a) Ultrasound shows a mixed solid cystic mass with predominantly solid features. On the 3-T T2-weighted high-resolution (b), unenhanced (c) and enhanced (d, f) T1 fat-saturated LAVA and diffusion-weighted images b = 1,200 mm/s2 (e), imaging features resemble a mucinous cystadenocarcinoma. d, e The lacy pattern caused by the enhancing solid elements (representing thyroid tissue) can be seen on T1 post-contrast imaging (d) and diffusion imaging (e) might be the only feature to suggest a struma. d, f Ascites is present (A) as well as extracapsular extension which is seen as tumour nodules on the capsular surface (arrow). d, e Some contrast medium uptake is shown in the tissues between the ovary and pelvic sidewall on the right (arrow). b, d, e A simple cyst arising from the right ovary does not present with restricted diffusion (arrowheads). CC-BY-SA Dujardin MI, Sekhri P, Turnbull LW. Struma ovarii: role of imaging? Insights into Imaging. 2014;5(1):41-51. doi:10.1007/s13244-013-0303-3.