Learning objectives
Describe a MRI guided approach to differential diagnosis of ovarian mass based on morphological appearance.
Discuss the value of MR imaging in differentiation between benign and malignant ovarian mass.
Review the key characteristics helpful in the diagnosis of certain ovarian tumors.
Background
Finding an ovarian mass is common in everyday practice.
While the majority of ovarian masses are found using ultrasound,
MRI can provide additional specificity for adnexal masses that are indeterminate on US.
For instance,
fat and haemorrhage are both hyperintense on T1-weighted images,
but fat-suppressed T1-weighted imaging can distinguish between lesions containing fat (such as a mature cystic teratoma) and containing haemorrhage (such as an endometrioma).
Though the achievement of a diagnosis leading to a specific histological subtype is almost always impossible using MRI,
it...
Findings and procedure details
We will discuss ovarian masses based on their morphologic appearance (cystic,
mixed or solid) listing the possible histological and their common RM features [1,2,5].
Note that the majority of the tumours belong to more than one morphologic type.
You can review the ovarian tumours classification by histological subtype in (table 1) [4].
It is important to have in mind that approximately 90% of malignant tumours are of epithelial origin.
Serous are the most common subtype followed by mucinous,
endometrioid and clear cell.
Unfortunately,
most patients...
Conclusion
Gadolinium-enhanced MR is helpful for differentiating ovarian lesions.
Morphologic appearance,
signal intensity characteristics,
contrast enhancement provide information for arriving to a correct diagnosis.
Personal information
Ilaria Mussetto (
[email protected]) University of Genoa- Scuola di Specializzazionein Radiodiagnostica.
References
Pietro Valerio Foti,
Giancarlo Attinà,
Saveria Spadola et al.
"MR imaging of ovarian masses: classification and differential diagnosis" 2016 Springer.
Izumi Imaoka,
Akihiko Wada,
Yasushi Kaji,
et al.
"Developing an MR Imaging Strategy for Diagnosis of Ovarian Masses" 2006 RadioGraphics.
Iyer VR,
Lee SI et al.
“ MRI,CT and PET\CT for ovarian cancer detection and adnexal lesion characterization” 2010 AJR Am J Roentgeno.
World Health Organization Classification of Tumours 2003 Pathology and genetics of tumours of the breast and female genital organs.
IARC.
A.
L....