Bartholin Cyst on Radiology Reports: What It Means
A Bartholin cyst is a common fluid-filled sac that develops near the vaginal opening. These cysts form when the Bartholin gland duct becomes blocked, causing fluid to build up. While most Bartholin cysts are diagnosed during a physical exam, they can also appear on imaging studies such as ultrasound, CT, or MRI.
What Is a Bartholin Cyst?
The Bartholin glands are two small glands located on each side of the vaginal opening. Their job is to produce lubrication. If the duct that drains one of these glands becomes blocked, a cyst can form. These cysts are usually painless unless they become infected, in which case they may turn into an abscess.
Radiology studies often detect these cysts even when a patient is being imaged for unrelated reasons. Imaging provides the size, location, and whether the cyst has features of infection.
How Bartholin Cysts Appear on Ultrasound
Typical Ultrasound Appearance
Ultrasound can be used to evaluate a suspected Bartholin cyst. Because ultrasound uses sound waves instead of radiation, it is safe and provides immediate information.
On ultrasound, a Bartholin cyst usually appears as:
-
A round or oval fluid-filled pocket.
-
A structure with thin, well-defined walls.
-
A simple, clear fluid interior that looks uniformly dark.
These features indicate a simple cyst, which is almost always benign.
When Ultrasound Suggests Infection
If the cyst becomes infected, the ultrasound may show:
-
Thicker walls.
-
Internal debris or cloudy fluid.
-
Increased blood flow in surrounding tissue.
These signs may indicate a Bartholin abscess, which often requires treatment.
Bartholin Cysts on CT Scans
Why a CT Might Show the Cyst
CT scans are not typically used to diagnose Bartholin cysts, but they occasionally reveal them when imaging the pelvis for other reasons, such as pain or trauma.
CT Appearance
On CT, a Bartholin cyst typically appears as:
-
A low-density fluid-filled structure.
-
A smooth, rounded mass near the lower vagina.
-
No solid components in simple cysts.
If infection is present, the cyst may appear more complex, with surrounding inflammation or slightly higher density fluid. CT can also help distinguish a cyst from other pelvic masses.
MRI Evaluation of Bartholin Cysts
When MRI Is Used
MRI provides the most detailed view of soft tissues and may be recommended when:
-
The diagnosis is uncertain.
-
The cyst appears unusual.
-
There is concern for tumor.
-
A patient has persistent symptoms despite treatment.
MRI Appearance
Typical MRI features include:
-
Bright fluid on T2-weighted images.
-
Darker fluid on T1-weighted images.
-
A thin, smooth wall.
MRI can show whether the cyst is simple or complicated by infection or bleeding. MRI can also suggest an alternative diagnosis.
Are Bartholin Cysts Dangerous?
Most Bartholin cysts are benign and do not pose a health risk. Many are small and cause no symptoms, especially when discovered incidentally on imaging.
However, a few situations require medical attention:
-
Pain or swelling.
-
Fever or signs of infection.
-
Rapid growth.
-
Recurrent cysts
Imaging helps differentiate a simple cyst from those that may require treatment.
How Doctors Manage Bartholin Cysts
Imaging results guide treatment decisions. Common management options include:
Observation
Asymptomatic cysts often require no treatment. If a radiology report describes a “simple Bartholin cyst” with benign imaging features, many doctors simply monitor it.
Warm Soaks
For mild symptoms, warm sitz baths can help reduce discomfort and encourage natural drainage.
Drainage Procedures
If the cyst is painful or infected, a minor office procedure may be needed:
-
Incision and drainage.
-
Word catheter placement.
-
Marsupialization for recurrent cysts.
Imaging can help confirm the diagnosis and rule out other causes before these procedures.
When Imaging Results Are Uncertain
Occasionally, a cyst may have atypical features. This may prompt:
-
Repeat imaging.
-
Referral to a gynecologist.
-
MRI for further characterization.
Conclusion
A Bartholin cyst on a radiology report is a common and typically benign finding. Imaging helps confirm the diagnosis and distinguish between a simple cyst and an abscess. Most cysts are easily managed or simply monitored, especially when found incidentally during imaging for other concerns. Understanding how these cysts appear on imaging tests can help you feel more confident and informed when reviewing your results with your doctor.
References
https://pmc.ncbi.nlm.nih.gov/articles/PMC3448931/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4483306/
https://pubs.rsna.org/doi/full/10.1148/rg.342135086