abstract
OBJECTIVE:
We
propose a Magnetic Resonance Imaging (MRI) guided approach to
differential diagnosis of ovarian tumours based on morphological
appearance.
BACKGROUND:
Characterization
of ovarian lesions is of great importance in order to plan adequate
therapeutic procedures, and may influence patient's management. Optimal
assessment of adnexal masses requires a multidisciplinary approach,
based on physical examination, laboratory tests and imaging techniques.
Primary ovarian tumours can be classified into three main categories
according to tumour origin: epithelial, germ cell and sex cord-stromal
tumours. Ovarian neoplasms may be benign, borderline or malignant. Using
an imaging-guided approach based on morphological appearance, we
classified adnexal masses into four main groups: unilocular cyst,
multilocular cyst, cystic and solid, predominantly solid. We describe MR
signal intensity features and enhancement behaviour of ovarian lesions
using pathologically proven examples from our institution.
CONCLUSION:
MRI
is an essential problem-solving tool to determine the site of origin of
a pelvic mass, to characterize an adnexal mass, and to detect local
invasion. The main advantages of MRI are the high contrast resolution
and lack of ionizing radiation exposure. Although different pathological
conditions may show similar radiologic manifestations, radiologists
should be aware of MRI features of ovarian lesions that may orientate
differential diagnosis.
TEACHING POINTS:
•
Diagnostic imaging plays a crucial role in detection, characterization
and staging of adnexal masses. • Characterization of an ovarian lesion
may influence patient's management. • Different pathological conditions
may have similar radiologic manifestations. • Non-neoplastic lesions
should always be taken into consideration.
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