MR features of physiologic and benign conditions of the ovary

Abstract

In reproductive women, various physiologic conditions can cause morphologic changes of the ovary, resembling pathologic conditions. Benign ovarian diseases can also simulate malignancies. Magnetic resonance imaging (MRI) can play an important role in establishing accurate diagnosis. Functional cysts should not be confused with cystic neoplasms. Corpus luteum cysts typically have a thick wall and are occasionally hemorrhagic. Multicystic lesions that may mimic cystic neoplasms include hyperreactio luteinalis, ovarian hyperstimulation syndrome, and polycystic ovary syndrome. Recognition of clinical settings can help establish diagnosis. In endometrial cysts, MRI usually provides specific diagnosis; however, decidual change during pregnancy should not be confused with secondary neoplasm. Peritoneal inclusion cysts can be distinguished from cystic neoplasms by recognition of their characteristic configurations. Ovarian torsion and massive ovarian edema may mimic solid malignant tumors. Recognition of normal follicles and anatomic structures is useful in diagnosing these conditions. In pelvic inflammatory diseases, transfascial spread of the lesion should not be confused with invasive malignant tumors. Radiologic identification of abscess formation can be a diagnostic clue. Many benign tumors, including teratoma, Brenner tumor, and sex-cord stromal tumor, frequently show characteristic MRI features. Knowledge of MRI features of these conditions is essential in establishing accurate diagnosis and determining appropriate treatment.

Diffusion-weighted Imaging of Ovarian Torsion: Usefulness of Apparent Diffusion Coefficient (ADC) Values for the Detection of Hemorrhagic Infarction

“…2 Meanwhile, MR imaging has a substantial advantage in terms of depiction of hemorrhagic infarction following ovarian torsion because of its high sensitivity for hemorrhage. However, signal intensity of hemorrhage depends on the On T 1 -weighted images, some torsed ovaries with hemorrhagic infarction showed hyperintensity, 2,[8][9][10] but others demonstrated hypointensity. 3,11,12 Furthermore, due to passive congestion, T 1 -weighted images depicted a torsed ovary without hemorrhagic infarction as hyperintense.…”

•Pelvic magnetic resonance imaging in gynecologic masses

“…İnsidansı %0,6-1 arasındadır. 13 Bizim ça-lışmamızda bilateral endometrioma mevcut bir olguda semisolid görünümde borderline seröz tümör eşlik etmekteydi (Resim 2). Dünya Sağlık Örgütü tarafından over tümörleri 3 gruba ayrılmaktadır; epiteliyal, seks kord stromal ve germ hücreli tümörler.…”

Cystic lesions of the female reproductive system: a review

“…This phenomenon is called shading (1). It is important to perform fat saturation techniques on MRI in order to distinguish this high signal intensity on unenhanced T1 changes, while on T2 the cyst compound will be low signal intensity with high signal intensity mural nodules (1).…”

“…1% of endometriomas undergo malignant transformation into endometrioid adenocarcinoma and clearcell carcinoma (1). Decidual changes of an endometrioma cyst wall during pregnancy may resemble solid malignant components.…”

“…Magnetic resonance imaging (MRI) on the other hand is known to be a valuable adjunctive modality for the cystic lesion workup (1). High-resolution multi-planar MRI imaging using a dedicated phased array coil allows detailed anatomic pelvic evaluation.…”