📄 SCRS

Abdominal aortic aneurysm
(AAA)

Abdominal aortic aneurysm (AAA) ultrasound case study

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Reporting Panel

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Abdominal ayorta Pathology

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View detailed

USG

Abdominal aortic aneurysm (AAA) ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Infrarenal abdominal aortic aneurysm (AAA)	View Report Line
2	Suprarenal abdominal aortic aneurysm (AAA)	View Report Line
3	Juxtarenal abdominal aortic aneurysm (AAA)	View Report Line
4	Pararenal abdominal aortic aneurysm (AAA)	View Report Line
5	Aortoiliac aneurysm	View Report Line
	Based on Etiology
6	Degenerative (Atherosclerotic) abdominal aortic aneurysm (AAA)	View Report Line
7	Inflammatory abdominal aortic aneurysm (AAA)	View Report Line
8	Mycotic (Infected) abdominal aortic aneurysm (AAA)	View Report Line
9	Traumatic abdominal aortic aneurysm	View Report Line
10	Pseudoaneurysm (False Aneurysm) of the abdominal aorta	View Report Line
	Based on Integrity
11	Intact abdominal aortic aneurysm (AAA)	View Report Line
12	Leaking abdominal aortic aneurysm (AAA)	View Report Line
13	Ruptured abdominal aortic aneurysm (AAA)	View Report Line

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CASE–1
Abdominal Aortic Aneurysm (AAA)

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Clinical History

A 68-year-old male presented with a history of pulsatile abdominal fullness and intermittent abdominal discomfort. Ultrasound examination of the abdominal aorta was performed to evaluate for aneurysmal dilatation.

Ultrasound Findings

Ultrasound examination demonstrates a fusiform dilatation of the infrarenal abdominal aorta, measuring 4.8 × 4.5 cm in maximum transverse diameter. The aneurysmal sac contains eccentric mural thrombus with a central patent lumen demonstrating normal color Doppler flow. The aneurysm extends over a length of approximately 6.2 cm. No evidence of aneurysmal rupture, periaortic hematoma, or free intraperitoneal fluid is identified. The bilateral common iliac arteries are of normal caliber.

Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen.

Report Line

Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 4.8 × 4.5 cm is noted, containing eccentric mural thrombus with a patent central lumen. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.

Impression

Infrarenal abdominal aortic aneurysm (AAA) No sonographic evidence of rupture.

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Recommendation

Correlate clinically and with cardiovascular risk factors. Vascular surgery consultation is recommended. Periodic ultrasound surveillance is advised for aneurysms less than 5.5 cm in diameter. Urgent evaluation is indicated if there is rapid aneurysm enlargement, severe abdominal or back pain, or suspicion of aneurysm rupture.

Key Learning Points

• Abdominal aortic aneurysm (AAA) is defined as an abdominal aortic diameter of 3.0 cm or greater.
• Most AAAs occur in the infrarenal abdominal aorta.
• Ultrasound is the preferred screening and surveillance modality because it is rapid, accurate, and non-invasive.
• Mural thrombus is commonly present within larger aneurysms.
• Color Doppler demonstrates a patent central lumen with surrounding thrombus.
• The risk of rupture increases significantly when the aneurysm diameter exceeds 5.5 cm or shows rapid interval growth.
• Differential diagnoses include aortic ectasia, pseudoaneurysm, penetrating atherosclerotic ulcer, and aortic dissection.

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CASE–2
Suprarenal Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform suprarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen.

Report Line

Fusiform aneurysmal dilatation of the suprarenal abdominal aorta measuring approximately 4.8 × 4.5 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm is located above the origins of both renal arteries. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.

Impression

Suprarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus.
No sonographic evidence of rupture.

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CASE–3
Juxtarenal Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform juxtarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen.

Report Line

Fusiform aneurysmal dilatation of the juxtarenal abdominal aorta measuring approximately 4.8 × 4.5 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm extends to the level of the renal artery origins without involving the renal arteries. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.

Impression

Juxtarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus.
No sonographic evidence of rupture.

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CASE–4
Pararenal Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform pararenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen and involvement of the renal artery origin.

Report Line

Fusiform aneurysmal dilatation of the pararenal abdominal aorta measuring approximately 4.9 × 4.6 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm involves the origin of one renal artery. No sonographic evidence of aneurysm rupture, periaortic hematoma, or retroperitoneal collection is identified.

Impression

Pararenal abdominal aortic aneurysm (AAA) involving the renal artery origin with eccentric mural thrombus.
No sonographic evidence of rupture.

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CASE–5
Aortoiliac Aneurysm

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform abdominal aortic aneurysm extending into the common iliac arteries (aortoiliac aneurysm) with eccentric mural thrombus surrounding a patent central lumen.

Report Line

Fusiform aneurysmal dilatation of the distal abdominal aorta measuring approximately 5.2 × 4.9 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm extends into the bilateral common iliac arteries, consistent with an aortoiliac aneurysm. No sonographic evidence of aneurysm rupture, periaortic hematoma, or retroperitoneal collection is identified.

Impression

Aortoiliac aneurysm involving the distal abdominal aorta and bilateral common iliac arteries with eccentric mural thrombus.
No sonographic evidence of rupture.

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CASE–6
Degenerative (Atherosclerotic) Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus and diffuse calcified atherosclerotic plaques involving the aneurysmal wall.

Report Line

Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 5.0 × 4.7 cm is noted. The aneurysm contains eccentric mural thrombus with a patent central lumen. Multiple calcified atherosclerotic plaques are seen along the aortic wall, consistent with a degenerative (atherosclerotic) abdominal aortic aneurysm. No sonographic evidence of rupture or periaortic hematoma is identified.

Impression

Degenerative (atherosclerotic) infrarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus and diffuse calcified atherosclerotic plaque formation.
No sonographic evidence of rupture.

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CASE–7
Inflammatory Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with marked circumferential wall thickening, surrounding hypoechoic inflammatory soft tissue (periaortic cuff), and eccentric mural thrombus.

Report Line

Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 5.1 × 4.8 cm is noted with circumferential aneurysmal wall thickening, surrounding hypoechoic periaortic inflammatory soft tissue, and eccentric mural thrombus with a patent central lumen. The findings are consistent with an inflammatory abdominal aortic aneurysm. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.

Impression

Inflammatory abdominal aortic aneurysm (AAA) with circumferential wall thickening, periaortic inflammatory soft tissue, and eccentric mural thrombus.
No sonographic evidence of rupture.

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CASE–8
Mycotic (Infected) Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a saccular abdominal aortic aneurysm with an irregular thickened wall, surrounding periaortic inflammatory soft tissue, and eccentric mural thrombus, suspicious for a mycotic (infected) aneurysm.

Report Line

An irregular saccular aneurysmal dilatation of the abdominal aorta measuring approximately 4.6 × 4.3 cm is identified. The aneurysm demonstrates a thick irregular wall, eccentric mural thrombus, and surrounding periaortic inflammatory soft tissue. A patent central lumen is present on Color Doppler examination. The sonographic findings are highly suggestive of a mycotic (infected) abdominal aortic aneurysm. No definite sonographic evidence of rupture is identified.

Impression

Mycotic (infected) abdominal aortic aneurysm (AAA) with irregular aneurysmal wall, eccentric mural thrombus, and surrounding periaortic inflammatory changes.
No sonographic evidence of rupture.

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CASE–9
Traumatic Abdominal Aortic Aneurysm

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a focal saccular aneurysmal dilatation arising from the abdominal aorta with an irregular disrupted aortic wall, surrounding eccentric mural thrombus, and a patent central lumen following blunt abdominal trauma.

Report Line

A focal saccular aneurysmal dilatation measuring approximately 4.2 × 3.9 cm is identified arising from the abdominal aorta. The lesion demonstrates an irregular disrupted aortic wall, eccentric mural thrombus, and a patent central lumen on Color Doppler examination. The imaging features, in the appropriate clinical setting, are consistent with a traumatic abdominal aortic aneurysm. No sonographic evidence of active extravasation, rupture, or periaortic hematoma is identified.

Impression

Traumatic abdominal aortic aneurysm with focal saccular dilatation and eccentric mural thrombus.
No sonographic evidence of rupture.

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CASE–10
Pseudoaneurysm (False Aneurysm) of the Abdominal Aorta

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a saccular pseudoaneurysm arising from the abdominal aorta through a narrow neck, with turbulent bidirectional blood flow within the aneurysmal sac (yin-yang appearance on Color Doppler).

Report Line

A 4.1 × 3.8 cm saccular pseudoaneurysm is identified arising from the abdominal aorta through a narrow communicating neck. Color Doppler demonstrates turbulent bidirectional ("yin-yang") flow within the aneurysmal sac, with a characteristic to-and-fro waveform at the neck on spectral Doppler. The pseudoaneurysm is contained by surrounding soft tissues without sonographic evidence of free rupture or retroperitoneal hematoma.

Impression

Pseudoaneurysm (false aneurysm) of the abdominal aorta arising through a narrow neck, demonstrating characteristic Color and Spectral Doppler findings.
No sonographic evidence of free rupture.

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CASE–11
Intact Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen. The aneurysmal wall is intact without evidence of leakage or rupture.

Report Line

Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 4.9 × 4.6 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysmal wall appears intact. No sonographic evidence of periaortic hematoma, retroperitoneal fluid collection, leakage, or rupture is identified.

Impression

Intact infrarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus.
No sonographic evidence of aneurysm leakage or rupture.

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CASE–12
Leaking Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus, adjacent periaortic hypoechoic hematoma, and focal discontinuity of the aneurysmal wall, suggestive of a contained leak.

Report Line

Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 5.8 × 5.4 cm is identified with eccentric mural thrombus and a patent central lumen. A focal defect in the aneurysmal wall is associated with an adjacent periaortic hypoechoic collection/contained hematoma, consistent with a contained leaking abdominal aortic aneurysm. No free intraperitoneal fluid is identified on this examination.

Impression

Leaking infrarenal abdominal aortic aneurysm (AAA) with contained periaortic hematoma, highly suspicious for a contained rupture.
Urgent vascular surgical intervention is recommended.

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CASE–13
Ruptured Abdominal Aortic Aneurysm (AAA)

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Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a large fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus, disruption of the aneurysmal wall, and a large periaortic/retroperitoneal hematoma, consistent with aneurysm rupture.

Report Line

Large fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 6.8 × 6.2 cm is identified with eccentric mural thrombus and a patent residual lumen. There is focal disruption of the aneurysmal wall with an extensive periaortic and retroperitoneal hematoma, consistent with a ruptured abdominal aortic aneurysm. Associated free intraperitoneal fluid is noted, highly suggestive of active hemorrhage.

Impression

Ruptured infrarenal abdominal aortic aneurysm (AAA) with extensive retroperitoneal hematoma and sonographic evidence of active hemorrhage.
This is a life-threatening vascular emergency requiring immediate surgical intervention.

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Limy bile
(Milk of Calcium Bile)

Limy bile (Milk of Calcium Bile) ultrasound case study

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Reporting Panel

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Gall bladder Pathology

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View detailed

USG

Limy bile (Milk of Calcium Bile) ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Limy bile (Milk of Calcium Bile)	View Report Line
2	-	-
3	-	-
4	-	-
5	-	-

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CASE–1
Limy Bile (Milk of Calcium Bile)

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Clinical History

A 48-year-old female presented with recurrent right upper abdominal pain, particularly after meals. There was no history of jaundice or fever. Ultrasound examination of the hepatobiliary system was performed to evaluate suspected gallbladder pathology.

Ultrasound Findings

Ultrasound examination demonstrates a dependent echogenic material within the gallbladder lumen, producing dense posterior acoustic shadowing. The echogenic material layers dependently and changes position with patient movement, consistent with limy bile (milk of calcium bile). The gallbladder wall is normal in thickness without pericholecystic fluid. No intraluminal soft tissue mass is identified. The common bile duct is normal in caliber, and there is no evidence of intrahepatic biliary dilatation.

Gallbladder USG image. Longitudinal sonographic image demonstrates dependent echogenic milk of calcium bile (limy bile) within the gallbladder lumen producing dense posterior acoustic shadowing, without evidence of an intraluminal soft tissue mass.

Report Line

Dependent highly echogenic material producing dense posterior acoustic shadowing is noted within the gallbladder lumen, demonstrating positional layering, consistent with limy bile (milk of calcium bile). No gallbladder wall thickening, pericholecystic fluid, or biliary ductal dilatation is identified.

Impression

Limy bile (Milk of Calcium Bile) within the gallbladder.
No sonographic evidence of acute cholecystitis.

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Recommendation

Correlate with the patient's clinical symptoms and liver function tests. Surgical consultation may be considered in symptomatic patients or when associated with gallstones or chronic cholecystitis. Asymptomatic patients may be managed conservatively with clinical follow-up.

Key Learning Points

• Limy bile (milk of calcium bile) is a rare condition caused by precipitation of calcium carbonate within the gallbladder.
• Ultrasound demonstrates dependent echogenic material with dense posterior acoustic shadowing.
• The echogenic material typically layers dependently and changes position with patient movement.
• The gallbladder wall is often normal unless associated with chronic cholecystitis.
• Most cases are associated with cystic duct obstruction and may coexist with gallstones.
• CT typically demonstrates high-attenuation calcium-containing bile within the gallbladder.
• Differential diagnoses include gallstones, biliary sludge, porcelain gallbladder, emphysematous cholecystitis, and gallbladder neoplasm with calcification.

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Follicular cyst

Follicular cyst ultrasound case study

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Reporting Panel

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Ovarian Pathology

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View detailed

USG

Follicular cyst ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Lt. Ovarian Follicular cyst	View Report Line
2	-	-
3	-	-
4	-	-
5	-	-

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CASE–1
Left Ovarian Follicular Cyst

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Clinical History

A 26-year-old female presented with intermittent lower abdominal pain and menstrual irregularity. Pelvic ultrasound was performed for evaluation of the adnexa.

Ultrasound Findings

Ultrasound examination demonstrates a well-defined thin-walled unilocular anechoic cyst within the left ovary. The cyst demonstrates posterior acoustic enhancement without internal septations, mural nodules, papillary projections, or solid components. Color Doppler demonstrates no internal vascularity. The surrounding ovarian stroma is normal with preserved vascularity. The right ovary appears normal. No adnexal mass or free fluid is identified in the pelvis.

Pelvic ultrasound. Transverse sonographic image demonstrates a 19 × 20 mm simple follicular cyst within the left ovary, appearing as a thin-walled anechoic lesion with posterior acoustic enhancement and no internal solid component or vascularity.

Report Line

A 36 × 32 mm thin-walled unilocular anechoic cyst is identified within the left ovary, demonstrating posterior acoustic enhancement without internal septations, mural nodules, papillary projections, or internal vascularity. The appearance is consistent with a simple left ovarian follicular cyst.

Impression

Simple left ovarian follicular cyst.

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Recommendation

Correlate with the patient's menstrual history and clinical symptoms. In premenopausal women, a simple follicular cyst measuring less than 5 cm is typically physiological and usually resolves spontaneously. Follow-up pelvic ultrasound in 6–12 weeks may be considered if the cyst persists, enlarges, or symptoms continue. Gynecological consultation is recommended if complications such as torsion, rupture, or persistent enlargement are suspected.

Key Learning Points

• Follicular cysts are the most common physiological ovarian cysts in women of reproductive age.
• They appear as a thin-walled, unilocular, anechoic cyst with posterior acoustic enhancement.
• There should be no internal septations, mural nodules, papillary projections, or solid components.
• No internal vascularity is seen on Color Doppler, although normal peripheral ovarian stromal vascularity may be present.
• Most simple follicular cysts measuring <5 cm resolve spontaneously over one or two menstrual cycles.
• Large, persistent, or symptomatic cysts warrant follow-up imaging and possible gynecological evaluation.
• Differential diagnoses include corpus luteum cyst, hemorrhagic cyst, paraovarian cyst, and benign ovarian neoplasm.

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Vernix Caseosa

Vernix Caseosa ultrasound case study

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Reporting Panel

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Amniotic fluid Pathology

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USG

Vernix Caseosa ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Vernix Caseosa	View Report Line
2	Vernix Caseosa with meconium	-
3	-	-
4	-	-
5	-	-

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CASE–1
Vernix Caseosa in Amniotic Fluid

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Clinical History

A 29-year-old primigravida in the third trimester presented for a routine obstetric ultrasound examination. She reported normal fetal movements. There was no history of leaking per vaginum, fever, vaginal bleeding, or decreased fetal movements.

Ultrasound Findings

Obstetric ultrasound demonstrates a single live intrauterine fetus with biometric parameters corresponding to the gestational age. The amniotic fluid volume is within normal limits. Multiple fine mobile echogenic particulate echoes are seen suspended within the amniotic fluid, producing a mildly echogenic appearance. These particles demonstrate free movement with fetal activity and are most consistent with vernix caseosa. No focal amniotic fluid collection, cord abnormality, or sonographic evidence of fetal distress is identified.

Obstetric ultrasound. Echogenic particulate matter is seen freely floating within the amniotic fluid, consistent with vernix caseosa, a normal physiological finding in late pregnancy.

Report Line

Multiple fine mobile echogenic particles are visualized floating within the amniotic fluid. The sonographic appearance is most consistent with vernix caseosa. Amniotic fluid volume is adequate, and no sonographic evidence of fetal distress is identified. Ultrasound cannot reliably differentiate vernix from meconium.

Impression

Echogenic particulate matter within the amniotic fluid, most consistent with vernix caseosa. This is a normal physiological finding in the third trimester. No sonographic evidence of fetal compromise.

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Recommendation

Continue routine antenatal follow-up. No specific intervention is required for isolated sonographic evidence of vernix caseosa. If there are clinical concerns regarding fetal well-being, including decreased fetal movements or abnormal fetal heart rate, appropriate obstetric evaluation should be performed, as ultrasound alone cannot reliably distinguish vernix caseosa from meconium-stained amniotic fluid.

Key Learning Points

• Vernix caseosa is the most common cause of echogenic particles within the amniotic fluid during the third trimester.
• It appears as fine, freely mobile echogenic particulate matter suspended in the amniotic fluid.
• Vernix caseosa is a normal physiological finding and does not indicate fetal distress.
• Ultrasound cannot reliably differentiate vernix from meconium.
• Clinical findings and fetal surveillance remain essential when meconium-stained amniotic fluid is suspected.
• Normal amniotic fluid volume and reassuring fetal assessment support a benign interpretation.
• No treatment or additional imaging is required for isolated vernix caseosa.

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Corpus luteum cyst

Corpus luteum cyst ultrasound case study

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Reporting Panel

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Ovarian Pathology

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View detailed

USG

corpus luteum cyst ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Left corpus luteum cyst with GS	View Report Line
2	Lt. ovarian Corpus luteum cyst ("ring of fire" sign).	View Report Line
3		-
4	-	-
5	-	-

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CASE–1
Early Intrauterine Pregnancy with Left Ovarian Corpus Luteum Cyst

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Clinical History

A 28-year-old female presented with a positive urine pregnancy test and amenorrhea. Pelvic ultrasound was performed for confirmation and dating of pregnancy.

Ultrasound Findings

Ultrasound examination demonstrates an intrauterine gestational sac (GS) corresponding to an estimated gestational age of approximately 4 weeks 6 days. A well-defined, thin-walled unilocular cyst is noted within the left ovary. The cyst demonstrates posterior acoustic enhancement without internal septations, mural nodules, papillary projections, or solid components. No internal vascularity is identified on Color Doppler examination. The right ovary appears normal. No adnexal mass or free fluid is seen in the pelvis.

Pelvic ultrasound. Transverse sonographic image demonstrates an early intrauterine gestational sac (GS) and a 35 × 42 mm left ovarian corpus luteum cyst with a thin wall, posterior acoustic enhancement, and no suspicious internal features.

Report Line

An intrauterine gestational sac (GS) corresponding to approximately 4 weeks 6 days is identified. A 35 × 42 mm thin-walled unilocular cyst is present within the left ovary, demonstrating posterior acoustic enhancement without septations, mural nodules, papillary projections, or internal vascularity. Findings are consistent with a physiological left ovarian corpus luteum cyst of pregnancy.

Impression

Early intrauterine pregnancy with gestational sac (approximately 4 weeks 6 days).
Physiological left ovarian corpus luteum cyst

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Recommendation

Routine obstetric follow-up is recommended. A follow-up ultrasound in 1–2 weeks may be performed to confirm yolk sac, fetal pole, and cardiac activity as appropriate. The corpus luteum cyst is a normal physiological finding in early pregnancy and typically regresses spontaneously by the second trimester.

Key Learning Points

• The corpus luteum cyst is a normal physiological finding during early pregnancy and supports progesterone production until placental function is established.
• It typically appears as a thin- or mildly thick-walled cyst with posterior acoustic enhancement and may measure up to 5 cm.
• Most corpus luteum cysts resolve spontaneously by the second trimester (14–16 weeks).
• Simple cystic morphology without solid components, papillary projections, or vascular nodules favors a benign diagnosis.
• Routine follow-up is generally sufficient unless the cyst enlarges, becomes symptomatic, or develops complex features.

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CASE–2
Left ovarian Corpus Luteum Cyst

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Clinical History

A 28-year-old female presented with a positive urine pregnancy test and amenorrhea. Pelvic ultrasound was performed for confirmation and dating of pregnancy.

Pelvic ultrasound. Transverse sonographic image demonstrates an a 35 × 42 mm left ovarian corpus luteum cyst with a thin wall and posterior acoustic enhancement. Color Doppler demonstrates the characteristic peripheral hypervascular "ring of fire" appearance, consistent with a physiological corpus luteum cyst.

Report Line

A 35 × 32 mm thin-walled unilocular cyst is present within the left ovary, demonstrating posterior acoustic enhancement and peripheral circumferential vascularity ("ring of fire" sign) on Color Doppler, without internal vascularity, septations, mural nodules, or papillary projections. Findings are consistent with a physiological left ovarian corpus luteum cyst.

Impression

Physiological left ovarian corpus luteum cyst.Characteristic peripheral "ring of fire" vascularity on Color Doppler.

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Ovarian Simple cyst

Ovarian Simple cyst ultrasound case study

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Reporting Panel

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Ovarian Pathology

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View detailed

USG

Ovarian Simple cyst ultrasound case study

Case Study Record

SN	Case Name	Report Line
1	Left Ovarian Simple cyst	View Report Line
2	-	-
3		-
4	-	-
5	-	-

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CASE–1
Left Ovarian Simple Cyst

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Clinical History

A 34-year-old female presented with intermittent lower abdominal pain and pelvic discomfort. There was no history of fever, abnormal uterine bleeding, weight loss, or known ovarian malignancy. Pelvic ultrasound was performed for further evaluation.

Ultrasound Findings

Ultrasound examination demonstrates a well-defined, thin-walled, unilocular anechoic cyst measuring approximately 3.8 × 3.2 cm arising from the left ovary. The cyst shows posterior acoustic enhancement without internal septations, mural nodules, papillary projections, or internal echoes. Color Doppler demonstrates no internal vascularity. The remaining left ovarian parenchyma appears normal. The right ovary is unremarkable. No adnexal mass or free fluid is identified in the pelvis.

Pelvic ultrasound. Transvers sonographic image demonstrates a well-circumscribed unilocular anechoic cyst within the left ovary showing posterior acoustic enhancement without septations or solid components, consistent with a simple ovarian cyst.

Report Line

A 55 x 43 mm thin-walled unilocular anechoic cyst is identified within the left ovary. The lesion demonstrates posterior acoustic enhancement without internal septations, mural nodules, papillary projections, or internal vascularity on Color Doppler examination. Findings are consistent with a simple left ovarian cyst.

Impression

Simple left ovarian cyst. No suspicious sonographic features.

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Recommendation

Clinical correlation is advised. In premenopausal women, simple ovarian cysts measuring less than 5 cm are usually physiological and generally do not require follow-up. Follow-up ultrasound may be considered if the cyst enlarges, becomes symptomatic, or develops complex sonographic features. In postmenopausal women, management should follow O-RADS and society guidelines.

Key Learning Points

• A simple ovarian cyst is a thin-walled, unilocular anechoic lesion with posterior acoustic enhancement.
• There should be no septations, mural nodules, papillary projections, or solid components.
• Absence of internal vascularity on Color Doppler supports a benign diagnosis.
• Simple cysts in premenopausal women are commonly physiological (dominant follicle or functional cyst).
• O-RADS US 2 lesions have an estimated malignancy risk of less than 1%.
• Most simple ovarian cysts measuring <5 cm in premenopausal women do not require imaging follow-up.
• Complex internal echoes, papillary projections, mural nodules, thick septations, or vascular solid components warrant further evaluation.

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