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Imaging evaluation of ovarian masses
Y Y Jeong1, E K Outwater, H K Kang
1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Summary
Imaging appearance is key for diagnosing adnexal masses, distinguishing benign from malignant ovarian tumors. Endovaginal ultrasonography and MRI offer valuable insights into mass characteristics, guiding clinical decisions.
Area of Science:
- Radiology
- Gynecologic Oncology
- Medical Imaging
Background:
- Adnexal masses pose diagnostic challenges due to the higher prevalence of benign over malignant conditions.
- Accurate assessment of malignancy risk is crucial and primarily relies on imaging findings.
Purpose of the Study:
- To review the role of various imaging modalities in the evaluation of adnexal masses.
- To highlight key morphologic and Doppler features indicative of malignancy.
- To outline a systematic approach to adnexal mass diagnosis using MRI.
Main Methods:
- Review of endovaginal ultrasonography (US) for initial assessment.
- Analysis of morphologic features (solid tissue, septations, papillary projections) and Color Doppler US.
- Discussion of Computed Tomography (CT) for staging and Magnetic Resonance (MR) imaging for complex cases.
Main Results:
- Endovaginal US is practical with high negative predictive value for ovarian tumors.
- Morphologic analysis accurately categorizes masses as low or high risk for malignancy.
- MRI provides detailed characterization of specific lesions like teratomas and endometriomas based on signal intensity.
Conclusions:
- Imaging appearance is critical for determining the suspicion of malignancy in adnexal masses.
- Endovaginal US and MRI are essential tools, each with specific roles in diagnosis and problem-solving.
- A systematic approach utilizing imaging features aids in accurate adnexal mass diagnosis.