Computed Tomography Appearance of Ovarian Cysts With Hyperenhancing Rim During the Menstrual Cycle in Women of Different Ages

Abstract

To determine the frequency and computed tomography (CT) characteristics of ovarian cysts in women of different ages. Five hundred ninety-five contrast-enhanced CT studies performed in 430 females aged 10 or older between January 2001 and December 2006 were retrospectively reviewed. For each study, we recorded the presence of ovarian cysts larger than 5 mm in diameter, with or without a hyperenhancing rim (HR, NR). The frequencies and CT characteristics of HR and NR cysts were analyzed according to phase of the menstrual cycle and patient age. Independent-sample t test, analysis of variance, chi test, and Fisher exact test were used to compare continuous data and categorical data between groups. Ovarian cysts were more frequently seen on CT studies of women between the ages of 20 and 49 years than on those of women older than 50 years (P = 0.004). Cysts with no HR were seen in every age group; HR cysts were present only in patients younger than 50 years. Cysts with HR were seen more frequently during periovulatory and secretory phase than during menses and proliferative phase (P = 0.003). Cysts with HR had a mean volume of 1.8 cm; NR cysts had a mean volume of 5.3 cm (P = 0.004). Cysts with HR had a thicker wall (3.4 mm vs imperceptible) and a higher attenuation value (31.4 vs 14.8 Hounsfield units) and were more commonly associated with pelvic fluid (P = 0.005) than were NR cysts. Cysts with HR, previously proven to represent corpus luteal cysts, can be readily seen on contrast-enhanced CT studies in women of reproductive age. Familiarity of the varied CT appearance of these cysts is essential, lest they be misinterpreted as pathological entities.