Korean J Radiol.  2003 Mar;4(1):42-45. 10.3348/kjr.2003.4.1.42.

Ruptured Corpus Luteal Cyst: CT Findings

• Choi HJ
• Kim SH
• Kim SH
• Kim HC
• Park CM
• Lee HJ
• Moon MH
• Jeong JY

• KMID: 754041
• DOI: http://doi.org/10.3348/kjr.2003.4.1.42

Abstract

OBJECTIVE
To evaluate the CT findings of ruptured corpus luteal cysts. MATERIALS AND METHODS: Six patients with a surgically proven ruptured corpus luteal cyst were included in this series. The prospective CT findings were retrospectively analyzed in terms of the size and shape of the cyst, the thickness and enhancement pattern of its wall, the attenuation of its contents, and peritoneal fluid. RESULTS: The mean diameter of the cysts was 2.8 (range, 1.5-4.8) cm; three were round and three were oval. The mean thickness of the cyst wall was 4.7 (range, 1-10) mm; in all six cases it showed strong enhancement, and in three was discontinuous. In five of six cases, the cystic contents showed high attenuation. Peritoneal fluid was present in all cases, and its attenuation was higher, especially around the uterus and adnexa, than that of urine present in the bladder. CONCLUSION: In a woman in whom CT reveals the presence of an ovarian cyst with an enhancing rim and highly attenuated contents, as well as highly attenuated peritoneal fluid, a ruptured corpus luteal cyst should be suspected. Other possible evidence of this is focal interruption of the cyst wall and the presence of peritoneal fluid around the adnexa.

Keyword

Computed tomography (CT) ; Cysts; Hemorrhage; Ovary

Figure

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  Fig. 1 A 32-year-old woman with severe pelvic pain and a negative pregnancy test. Contrast-enhanced CT scan at the level of the pelvis shows a cystic mass in the right adnexa, with wall enhancement (arrow). There is interruption of the enhancing wall, suggesting rupture of cyst (arrowheads). Note the presence of high-attenuated peritoneal fluid and cystic content.

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  Fig. 2 A 32-year-old woman with severe pelvic pain and a negative pregnancy test. A. Non-enhanced CT scan of the pelvis reveals the presence of high-attenuated peritoneal fluid in the pelvic cavity, due to hemoperitoneum. There is a cystic lesion in the right adnexa (arrow). B. Contrast-enhanced CT shows that the thick wall of the cystic mass (arrow) is well enhanced, interruption is apparent (arrowheads).

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  Fig. 3 A 34-year-old woman with lower abdominal pain and anemia. A. Non-enhanced CT scan of the pelvis shows high-attenuated pelvic fluid, suggesting hemoperitoneum. The right adnexa contains a cystic lesion (arrow). B. Contrast-enhanced CT shows that the wall of the right adnexal lesion is well enhanced. In the cystic wall, suspicious interruptions (arrowheads) are apparent.

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  Fig. 4 A 19-year-old woman with severe pelvic pain and a negative pregnancy test. At contrast-enhanced CT, the wall of the cystic mass (arrow) is well enhanced. Note the presence of high-attenuated fluid in the cul-de sac and dependent portion of the cyst.

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