(Ultrasound Review) - This prospective study of 23 neonates, infants and young children with lower abdominal cystic masses assessed the value of the 'daughter cyst' sign in diagnosing ovarian cysts.
The researchers defined the 'daughter cyst' sign as the presence of a small cyst along the wall of a cystic mass. In neonates, infants and young children, normal ovaries have small cystic masses that represent unstimulated follicles, but the authors sought to show that the daughter cyst sign would distinguish the follicles of ovarian cysts.
Other pelvic cystic masses include: intestinal duplication cyst, meconium pseudocyst, hydrometrocolpos, lymphangioma, anterior meningeocele, mesenteric cyst and urachal cyst. These are mostly congenital cysts requiring surgical removal. Ovarian cysts, in contrast, can spontaneously resolve during the first few months of life. Surgical intervention may be avoided if the correct diagnosis of ovarian cyst is made.
Ultrasound examinations were performed using a 5-MHz curved array or 7-MHz linear array transducer and an Acuson 128XP. The walls of the cysts were carefully imaged in search of daughter cysts. These small cysts can either protrude into the lumen of the large cystic mass or lie along the outer wall.
Daughter cysts were demonstrated in 82% of the patients with ovarian cysts. Seven involuted during the first seven months of life, and in the remaining four girls, the cysts were surgically removed. Pathology confirmed they were ovarian follicles.
Results indicated that the daughter cyst sign showed a sensitivity of 82% and a specificity of 100% in differentiating ovarian cysts from other pelvic cysts.
"The daughter cyst sign is a specific sonographic finding for an ovarian cyst and may be useful in differentiating uncomplicated ovarian cysts from other cystic masses in neonates, infants, and young children," the authors conclude.
" 'Daughter cyst' sign: a sonographic finding of ovarian cyst in neonates, infants, and young children," by Hee-Jung Lee et al, Dept of Diagnostic Radiology, Keimyung Universty School of Medicine, Dongsan Medical Center, 194, Dongsan-dong, Jung-Ku,Taegu 700-310, Korea. AJR 2000; 174:1013-1015.
By Ultrasound Review
August 16, 2000
