Pathology of the Ovaries - Ultrasound Review Flashcards

A set of Q&A style flashcards covering anatomy, normal ultrasound appearance, cycle phases, Doppler indices, cysts, endometriosis, torsion, and adnexal masses from the lecture notes.

What are the ovaries and where are they located?

Paired, almond-shaped structures located on each side of the uterus near the lateral pelvic wall.

Where are ovaries usually found in relation to an anteflexed uterus?

Laterally or posterolaterally near the uterus.

How does uterus position affect ovarian location?

If the uterus is to one side, the ipsilateral ovary may be superior to the fundus. In a retroverted uterus, they are lateral and superior to the fundus.

Where are ovaries found after a hysterectomy?

Medially and superior to the vaginal cuff, sometimes high in the pelvis or in the cul-de-sac.

What is the blood supply and drainage of the ovaries?

Ovarian arteries supply them from the abdominal aorta. The right ovarian vein drains into the IVC, and the left into the left renal vein.

What are the main parts of an ovary?

It's covered by the tunica albuginea; the medulla contains connective tissue and vessels; the cortex contains follicles.

Name some types of functional ovarian cysts.

Follicular, corpus luteum, hemorrhagic, and theca-lutein cysts.

What causes a follicular cyst?

It forms when a dominant follicle doesn't ovulate and keeps growing.

What is a corpus luteum cyst?

A cyst that forms when the corpus luteum fails to resorb or hemorrhages, filled with blood and fluid.

What is a hemorrhagic cyst?

A functional cyst with bleeding inside it.

When do Theca-Lutein cysts occur?

They are associated with high hCG levels, seen in conditions like trophoblastic disease or during fertility treatment.

What causes Ovarian Hyperstimulation Syndrome (OHSS)?

It's a complication of fertility treatments like ovulation induction.

What is the 'string of pearls' sign associated with?

Polycystic Ovarian Syndrome (PCOS), where ovaries have many small peripheral cysts.

What is a peritoneal inclusion cyst?

A cyst formed when adhesions trap peritoneal fluid around the ovaries, lined with mesothelial cells.

Where are paraovarian cysts found?

Adjacent to the ovary, within the broad ligament.

What is the basic difference between endometriosis and adenomyosis?

Endometriosis is endometrial tissue outside the uterus, while adenomyosis is within the uterine wall (myometrium).

What is an endometrioma sometimes called?

A chocolate cyst.

What is ovarian torsion?

The twisting of the ovarian pedicle, cutting off blood flow.

What are some ultrasound signs of ovarian torsion?

An enlarged ovary, no Doppler flow, or a 'whirlpool sign'.

What does the 'whirlpool' sign indicate?

A twisted ovarian pedicle, seen in ovarian torsion.

What is a common symptom of ovarian torsion?

Acute severe unilateral lower abdominal pain.

Are functional ovarian cysts usually benign?

Yes, functional cysts are typically benign and may resolve on their own.

What are characteristics of a benign simple cyst on ultrasound?

Thin smooth wall, anechoic (fluid-filled) content, and acoustic enhancement.

What ultrasound features suggest a potentially malignant ovarian mass?

Irregular walls, thick septations, solid components, or signs of spread.

How is ovarian volume calculated?

Length x width x height x 0.523.

What do postmenopausal ovaries typically look like on ultrasound?

They are usually atrophic, smaller, and without discrete follicles.

What main hormones do ovaries produce?

Estrogens, androgens, and progesterone.

What do endometriomas look like on ultrasound?

Cystic ovarian masses with diffuse low-level internal echoes.

What is localized endometriosis?

It forms discrete masses called endometriomas or chocolate cysts in the ovary.

How can Doppler help assess ovarian masses for malignancy?

Low-resistance flow or increased diastolic flow may suggest malignancy, but it's not a definitive sign alone.

What are key ultrasound signs of a benign adnexal cyst?

Thin walled, simple, anechoic with posterior acoustic enhancement.

What might an enlarged postmenopausal ovary with increased vascularity indicate?

Potential malignancy