A Case of Ruptured Decidualized Ovarian Endometrioma: Usefulness of Serial MRI for Determining Adequate Management

Figure 1

Magnetic resonance imaging (MRI) of the pelvis performed at 21 weeks of gestation. (a) Axial T1-weighted image. (b) Axial T2-weighted image. (c) Sagittal T2-weighted image. (d) Axial diffusion-weighted image (b factor: 1000 s/mm²). (e) Apparent diffusion coefficient (ADC) map. MRI shows a well-circumscribed teardrop-shaped cystic lesion with mural nodules measuring in the right ovary. The cystic lesion shows uniformly marked high signal intensity on the T1-weighted image (a, asterisk) and intermediate signal intensity (b, asterisk) on T2-weighted images consistent with ovarian endometrioma. The mural nodules show intermediate to high signal intensity on T2-weighted images (b, c; short arrows) similar to the placenta (c, long arrows). Diffusion-weighted image (d, short arrows) and ADC map (e, short arrows) show the mural nodules with a high ADC value (). Based on these imaging findings, we diagnosed a decidualized ovarian endometrioma.

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