Small echogenic foci in the ovaries: correlation with histologic findings.
OBJECTIVE
The purpose of this study was to determine the histologic correlate of small echogenic foci in the ovary and to assess for any association with endometriosis or endosalpingiosis.


METHODS
Women planning to have a normal ovary surgically removed were scanned preoperatively with transvaginal sonography. If echogenic foci were present in either normal ovary on the preoperative scan, the removed ovary was scanned in a saline bath, and the surface was marked with india ink over an echogenic focus. Histologic sections were then obtained at the marked site.


RESULTS
Echogenic foci were detected in 23 ovaries of 16 women. Possible causes were found in 17 of the 23 ovaries: hemosiderin in 6 cases, calcification in 5 cases, hemosiderin and calcification in 2 cases, clusters of inclusion cysts in 2 cases, 1 of which also had hemosiderin, and dense cortical nodules in 2 cases. Histologic findings were benign in all cases except in 1 patient who had primary peritoneal carcinoma unrelated to the echogenic foci. One ovary in another patient had both endosalpingiosis and endometriosis. One other patient had endometriosis involving a fallopian tube but not the ovary. There were no other cases of endometriosis or endosalpingiosis.


CONCLUSIONS
Small echogenic foci in the ovaries are most frequently due to hemosiderin or calcification. A few small echogenic foci in the ovaries are associated with benign histologic changes and do not appear to be reliable indicators of endosalpingiosis or endometriosis.
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. brown.douglas@mayo.edu
Douglas L
DL
Brown
Mary C
MC
Frates
Michael G
MG
Muto
William R
WR
Welch
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*; D014621:Vagina