Peritoneal inclusion cysts and their relationship to the ovaries: evaluation with sonography.

Abstract

To evaluate with sonography the relationship of the ovary to the peritoneal inclusion cyst. The medical records, sonograms, and sonographic reports of 15 premenopausal women with surgically proved peritoneal inclusion cysts were examined. Twelve of these cases were examined prospectively. In another prospectively evaluated case, the sonogram was interpreted as revealing a peritoneal inclusion cyst; however, hydrosalpinx was confirmed with surgery. Thirteen women with peritoneal inclusion cysts had undergone pelvic surgery before sonography. Additional examination with computed tomography was performed in three women and with magnetic resonance imaging in another. The ovary was detected on sonograms in 12 of 15 women with peritoneal inclusion cysts. In nine of the 12 women, the ovary was demonstrated to be inside the cyst. Ten of 12 ovaries appeared normal. Cyst diameter ranged from 7.5 to 17.4 cm (mean, 11.6 cm). Sonograms of two cysts demonstrated internal echoes. Septa were seen in 11 of the 15 cysts. Cysts were ovoid in six women and irregular in nine; they were defined by adjacent pelvic structures. In premenopausal women with a history of pelvic surgery, the appearance on sonograms of the ovary inside a large, ovoid or irregular, anechoic cyst is characteristic of a peritoneal inclusion cyst.