Diagnostic utility of CT in differentiating between ruptured ovarian corpus luteal cyst and ruptured ectopic pregnancy with hemorrhage

Abstract

BackgroundTo evaluate the performance of computed tomography (CT) as a diagnostic aid to differentiate between ruptured ovarian corpus luteal cyst (ROCLC) and ruptured ectopic pregnancy with hemorrhage (REPWH).MethodsA total of 36 patients treated at our hospitals for ROCLC and REPWH from June 2014 to August 2017 were included in this study. Based on the diagnosis, the study population was divided into ROCLC group (n = 21) and REPWH group (n = 15). CT scans were performed for all patients prior to treatment. The size of the cystic shadows and the depth of the pelvic effusion were analyzed and compared with independent sample Student’s t test and Fisher’s exact test.ResultsCystic shadows with maximum diameters ≥3.0 cm presented in 16 patients with ROCLC and 1 patient with REPWH, while 4 patients with ROCLC and 9 patients with REPWH exhibited cystic shadows with maximum diameters <3.0 cm. The mean diameters along the major and minor axes in the two groups were 3.76 ± 1.11 cm and 2.93 ± 0.98 cm, 1.96 ± 0.65 cm and 1.60 ± 0.55 cm, respectively (p < 0.001). The mean depth of the pelvic effusion in patients with ROCLC and REPWH were 5.20 ± 2.47 cm and 6.96 ± 2.07 cm, respectively (p = 0.038).ConclusionThe cystic shadow of ROCLC is larger than that of the REPWH. The depth of the pelvic effusion of REPWH is deeper than that of the ROCLC. CT can help differentiate between ROCLC and REPWH based on the size of the cystic shadow and the depth of pelvic effusion in the adnexal area.

Unruptured ovarian ectopic pregnancy: Two case reports and literature review

“…However, its application in detecting ovarian pregnancies is limited. Although a CT scan can help distinguish a ruptured luteal cyst from a ruptured ectopic pregnancy with bleeding in some cases ( Liu et al, 2018 ), CT examination was mostly used to rule out other causes of intraperitoneal hemorrhage in ruptured ovarian pregnancies.…”

Rupture of Ectopic Ovarian Pregnancy Accompanied by Massive Intra-abdominal Bleeding and Disorder of the Coagulation Mechanism: A Rare and Life-Threatening Obstetric Complication

“…However, the ultrasound findings are not typical in the case of ruptured ovarian pregnancy and massive bleeding [17]. In some cases, a Computed Tomography scan can help distinguish between a ruptured luteal cyst and ruptured ectopic pregnancy with bleeding [18]. In most cases, the diagnosis of ovarian pregnancy is based on histopathological findings [19].…”

Changing trends in the management of corpus luteum haemorrhage

“…CT scan aids in clinching the diagnosis by the appearance and size of the adnexal mass, cystic shadow and depth of the pelvic collection. 12 Corpus luteum will appear like a wellcircumscribed unilocular lesion with inhomogeneous contrast enhancement and a thickened cyst wall on a CT scan. Source of bleeding can be identified by locating sentinel clot, which appears as an area of highest attenuation.…”