Synopsis
MR imaging of adnexal masses can optimally characterise lesions aiding treatment selection. This talk aims to discuss typical and unusual imaging appearances to guide the radiologist with discussion of imaging algorithms and clinical case discussion.Target audience: Radiologists involved in reviewing and reporting female pelvis MRI examinations.
Objectives: Enable the clinical radiologist to recognise the anatomical origins of adnexal masses and interrogate the MR imaging characteristics. Aid the radiologist in identifying typical imaging features for a confident diagnosis and to be more confident in the interpretation of challenging cases.
Content: The role of MRI in characterisation of adnexal masses will be discussed with reference to benign and malignant conditions. Distinguishing malignant features such as solid elements, wall thickening and thick septations will be presented. Distinguishing benign features such as fibrous tissue and the differential diagnoses for adnexal masses containing these elements will be discussed. The features that help to differentiate the anatomical origin of an adnexal mass will be discussed with sharing of difficult cases which presented challenges in the typical radiology reporting room. Current clinical MRI protocols that are necessary for adnexal mass characterisation will be discussed and the relevance of each sequence will be talked through with reference to clinical cases. For example in basic interpretation such as T1 weighted imaging and T1 fat saturated imaging for endometrioma versus dermoid in assessment of blood products versus fat but also with reference to more difficult complications of benign disease such as clear cell carcinoma of endometrioma and squamous cell malignant transformation of dermoid lesion. The role of diffusion-weighted imaging will be discussed and topical research on adnexal mass characterisation such as the ADNEX MR SCORING system will be discussed in reference to everyday clinical reporting.
Acknowledgements
Dr. E. Sala, Memorial Sloan Kettering Cancer Center, New York
Dr. S. Nougaret, Saint –Eloi- CHRU de
Montpellier
Dr. C. Reinhold, McGill University Health Centre, Montreal
Dr. S. Freeman and Dr. P. Moyle, Cambridge University Hospitals NHS Foundation Trust, Cambridge
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