Fig. 3

Acute presentation of endometriosis. Patient presented with intermenstrual vaginal bleeding and severe lower abdominal pain. a Transvaginal ultrasound demonstrates an ovarian cyst with an area of homogeneous internal echogenicity typical of an endometriotic cyst (black arrow). There is a focal area of clot retraction along the endometriotic cyst wall (white arrow). b Axial T1 image demonstrates bilateral complex adnexal cystic masses which contain high T1 material. c Axial T2 demonstrates intermediate signal intensity with ‘shading’ (black arrow), typical of endometriotic blood. The appearances are in keeping with bilateral haematosalpinges in a patient with endometriosis