How can the sonographer differentiate between a solid and cystic ovarian mass?

Differentiating between solid and cystic ovarian masses is crucial in ultrasound imaging, as it significantly influences management and treatment decisions. The presence or absence of internal echoes and the characteristics of any septations within the mass are key indicators.

Cystic masses typically have fluid-filled cavities and often appear anechoic (dark) on ultrasound, which suggests they contain no internal echoes. In contrast, solid masses exhibit increased echogenicity due to tissue or cellular components and may demonstrate a heterogeneous appearance because of varying texture or composition. Assessing for septations, which are thin walls within the mass, can provide additional clues; if present, they can indicate a more complex cystic structure or a solid mass rather than a simple cyst.

This approach focuses on the ultrasound characteristics of the mass, which are vital for proper diagnosis. Size measurement alone, evaluation of blood flow, or patient age may provide some context or additional information, but they do not directly inform the solid versus cystic distinction as effectively as the assessment of internal echoes and septations.