A sizeable oval-shaped pelvic mass is seen attaining its blood supply from engorged left gonadal vessels reflecting enlarged left ovary reaching up to 250 cc (9.5 x 8 x 6.5 cm). It exhibits marked loss of the cortico-medullary differentiation sequel to marked oedema and congestion, with residual peripherally located follicles. Diffuse reticular pattern of the intra-ovarian vascular tree reflecting blood stagnation reflecting massive ovarian oedema. No diffusion restriction.
Whorly appearance of the related free edge broad ligament containing prominent fallopian tube which shows marked vascular congestion and tortuosity confirming twisted pedicle.
It’s seen prolapsing into the Douglas pouch at right paramedian position (sonographically suspected right adnexal lesion) pushing the uterus into an exaggerated AVF axis and effacing the right ovary posteriorly.
Mild free pelvic fluid is also noted.
The right ovary revealed a cystic lesion of 5.5 cm with clear content, thin wall, and no soft tissue component.