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Organ | Sonographic diagnosis | Differential diagnosis |
Case number | US suspect | Appearance | US suspect | Differences |
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Bowel and pelvic diseases | #13 | Tarlov cyst (confirmed diagnosis at MRI scan) | Anechoic cyst between the posterior wall of the rectum and the sacrum | Bowel endometriosis (see cases #1 to #8 of Figure 1) | (i) Endometriosis never affects the posterior wall of the bowel (ii) External layers of the rectal wall are intact and smooth |
#14 | Presacral mass, probably a ganglioneuroma (confirmed diagnosis) | Apparently well-defined mass with fine low-level echoes; Doppler was considered not satisfactory | Bowel endometriosis (see cases #1 to #8 of Figure 1) Presacral endometriosis | (i) Endometriosis never affects the posterior wall of the bowel (ii) External layers of the rectal wall are intact and smooth (iii) Presacral endometriosis is never cystic as it appears as a solid not well-defined lesion |
#15 | Appendicular abscess (confirmed diagnosis) | The caecum was dislocated down into the pelvis; the appendix was thick and attached to the ovary; an irregular hypoechoic area between the two organs was seen | Endometrioma | (i) High inflammatory blood tests (ii) No previous menstrual symptoms |
#16 | Colonic diverticula (confirmed diagnosis by colonoscopy) | An external pouch of the sigmoid colon with a thickened wall and a hyperechoic content was seen | Bowel endometriosis (see cases #1 to #8 of Figure 1) | (i) It grows outwards (ii) Thick bowel wall (iii) Hyperechoic content |
#17 | Colonic diverticular abscess (confirmed diagnosis) | An undefined oval mass was identified between the uterus and the sigmoid colon. A transverse section demonstrated the presence of a diverticulum (external pouch of the sigmoid colon with a thick wall and hyperechoic content) with an intense Doppler positivity | Endometrioma Corpus luteum Ovarian abscess Bowel endometriosis (see cases #1 to #8, Figure 1) | (i) Diverticula grow outwards (ii) Thick bowel wall (iii) Hyperechoic content (iv) Vascularization (v) Inflammatory blood tests |
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