PMC8226026_01
Quantitative analysis using VueBoxTM software (Bracco Imaging, Germany). (A,B) Case 1: mature teratoma. (C,D) Case 2 Immature teratoma with potential malignant changes. (A,C) CEUS with contrast image (left) and B-mode (right) in parallel mode. Color coding of RT within the set ROI's. Green ROI in the solid portion of the teratomas. Yellow reference ROI in subcutaneous fat (A) or retroperitoneal (B). (C,D) Time-intensity curves:green curve: ROI measurement in the ovarian mass with visualization of PE, RT, TTP, AUC in case 1 and 2. Yellow curve: reference ROI.
fped-09-681404-g0001.jpg
PMC8226026_02_fped-09-681404-g0001.jpg
F1
PE was 117% (Figures 1B,D). Purely visual examination revealed very vigorous and irregular flooding of the bubble in the solid part (Figure 3C).
Case 1, a 16-year-old girl with a mature teratoma of the right ovary. (A), B-mode Ultrasound showing a large cystic structure. In it, a solid lobulated portion, the so-called Rokitansky nodule, is adherent (arrow) to the dorsal wall. Within the solid echogenic mass, there are centrally echo-free areas with dorsal extinction (dashed arrow). There is very delicate septation between the solid part and the cyst wall (curved arrow). (B) CEUS of the solid part and the intracystic septation in the contrast image (left) and the native B-mode (right) in parallel mode. Image sequence ~35 s after application of the contrast media i.v.: The intracystic membrane is very delicately detectable in the native B-mode (arrowhead) and accumulates contrast bubbles (dashed arrow). The contrast media shows strong perfusion with numerous microbubbles in the left part of the solid parts, the central part is excluded (star). In conjunction with the histological findings of the mature teratoma, this is a bony tooth.
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F2
Within the thin-walled cyst were a hyperechoic solid structure of about 4.2 cm and a delicate septum (Figure 2).
PMC8226026_02
Quantitative analysis using VueBoxTM software (Bracco Imaging, Germany). (A,B) Case 1: mature teratoma. (C,D) Case 2 Immature teratoma with potential malignant changes. (A,C) CEUS with contrast image (left) and B-mode (right) in parallel mode. Color coding of RT within the set ROI's. Green ROI in the solid portion of the teratomas. Yellow reference ROI in subcutaneous fat (A) or retroperitoneal (B). (C,D) Time-intensity curves:green curve: ROI measurement in the ovarian mass with visualization of PE, RT, TTP, AUC in case 1 and 2. Yellow curve: reference ROI.
fped-09-681404-g0001.jpg
PMC8226026_02_fped-09-681404-g0001.jpg
F1
PE was 117% (Figures 1B,D). Purely visual examination revealed very vigorous and irregular flooding of the bubble in the solid part (Figure 3C).
Case 2, 10-year-old girl with an immature teratoma with potential malignant changes. (A) B-mode ultrasound showing a cystic structure extending from the left ovary up to 16 cm in diameter. Within the cyst there is a solid part (arrow) measuring up to 7.5 cm. This is interspersed with an irregular surface (dashed arrow), inhomogeneous structure with multiple small cystoid lesions (white star). (B) In Doppler ultrasonography, no increased perfusion can be detected in the solid part (curved array). (C) Distribution pattern of contrast bubbles within the solid parts after 2 min. Strong enhancement with bizarre distribution within the irregularly configured solid mass (long arrow). (D) MRI of the pelvis shows the bizarre aspect of the solid mass with hyperintense cysts (black star) and irregularly configured hypointense stroma (black dashed arrow), (T2 TSE in paracoronal orientation).
fped-09-681404-g0003.jpg
PMC8226026_02_fped-09-681404-g0003.jpg
F3
A contained irregularly configured solid portion without calcifications was ~7.0 cm in size and with vigorous perfusion on Doppler ultrasonography (Figure 3). PE was 117% (Figures 1B,D). Purely visual examination revealed very vigorous and irregular flooding of the bubble in the solid part (Figure 3C).