Ovarian germ cell tumor MRI: Difference between revisions
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==Overview== | ==Overview== | ||
It is difficult to distinguish subtypes of ovarian germ cell tumor on MRI alone. The majority of ovarian germ cell tumors have a solid and cystic appearance with areas of hemorrhage and necrosis. On MRI, ovarian germ cell tumors may be characterized by T2: the septae are often hypointense or isointense T1 C+ (Gd): the septae often show marked enhancement (dysgerminoma), the presence of a prominent solid component containing calcifications and small foci of fat (mature teratoma), areas of haemorrhage can also be seen (yolk sac tumor).<ref name= xab> Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015</ref><ref name= abc> Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015</ref><ref name= xxx> Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015</ref> | It is difficult to distinguish subtypes of ovarian germ cell tumor on [[MRI]] alone. The majority of ovarian germ cell tumors have a solid and cystic appearance with areas of [[hemorrhage]] and [[necrosis]]. On MRI, ovarian germ cell tumors may be characterized by T2: the septae are often hypointense or isointense T1 C+ (Gd): the septae often show marked enhancement ([[dysgerminoma]]), the presence of a prominent solid component containing calcifications and small foci of [[fat]] (mature [[teratoma]]), areas of haemorrhage can also be seen (yolk sac tumor).<ref name= xab> Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015</ref><ref name= abc> Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015</ref><ref name= xxx> Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015</ref> | ||
==Pelvic MRI== | ==Pelvic MRI== | ||
'''Dysgerminomas '''<ref name= xab> Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015</ref> | '''Dysgerminomas '''<ref name= xab> Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015</ref> | ||
* Tumors are often seen divided into lobules by septa | * Tumors are often seen divided into lobules by [[septa]] | ||
* Reported signal characteristics include: | * Reported signal characteristics include: | ||
* T2: the septae are often hypointense | * T2: the septae are often hypointense | ||
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'''Mature (cystic) ovarian teratoma'''<ref name= abc> Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015</ref> | '''Mature (cystic) ovarian teratoma'''<ref name= abc> Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015</ref> | ||
* MR evaluation usually tends to be reserved for difficult cases, but is exquisitely sensitive to fat components | * MR evaluation usually tends to be reserved for difficult cases, but is exquisitely sensitive to fat components | ||
* Both fat suppression techniques and chemical shift artefact can be used to confirm the presence of fat | * Both [[fat]] suppression techniques and chemical shift artefact can be used to confirm the presence of fat | ||
* Enhancement is also able to identify solid invasive components, and as such can be used to accurately locally stage malignant variants | * Enhancement is also able to identify solid invasive components, and as such can be used to accurately locally stage malignant variants | ||
'''Immature ovarian teratoma'''<ref name= yyy> Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015</ref> | '''Immature ovarian teratoma'''<ref name= yyy> Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015</ref> | ||
* The presence of a prominent solid component containing calcifications and small foci of fat is suggestive. Cystic components may contain serous, mucinous, or fatty sebaceous material | * The presence of a prominent solid component containing calcifications and small foci of fat is suggestive. [[Cystic]] components may contain serous, mucinous, or fatty [[sebaceous]] material | ||
* Haemorrhage may be present | * Haemorrhage may be present | ||
'''Ovarian yolk sac tumor''' <ref name= xxx> Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015</ref> | '''Ovarian yolk sac tumor''' <ref name= xxx> Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015</ref> | ||
* They can be associated with prominent signal voids on MRI | * They can be associated with prominent signal voids on [[MRI]] | ||
* Areas of haemorrhage can also be seen | * Areas of haemorrhage can also be seen | ||
Revision as of 15:26, 24 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
Overview
It is difficult to distinguish subtypes of ovarian germ cell tumor on MRI alone. The majority of ovarian germ cell tumors have a solid and cystic appearance with areas of hemorrhage and necrosis. On MRI, ovarian germ cell tumors may be characterized by T2: the septae are often hypointense or isointense T1 C+ (Gd): the septae often show marked enhancement (dysgerminoma), the presence of a prominent solid component containing calcifications and small foci of fat (mature teratoma), areas of haemorrhage can also be seen (yolk sac tumor).[1][2][3]
Pelvic MRI
Dysgerminomas [1]
- Tumors are often seen divided into lobules by septa
- Reported signal characteristics include:
- T2: the septae are often hypointense
- isointense T1 C+ (Gd): the septae often show marked enhancement
Mature (cystic) ovarian teratoma[2]
- MR evaluation usually tends to be reserved for difficult cases, but is exquisitely sensitive to fat components
- Both fat suppression techniques and chemical shift artefact can be used to confirm the presence of fat
- Enhancement is also able to identify solid invasive components, and as such can be used to accurately locally stage malignant variants
Immature ovarian teratoma[4]
- The presence of a prominent solid component containing calcifications and small foci of fat is suggestive. Cystic components may contain serous, mucinous, or fatty sebaceous material
- Haemorrhage may be present
Ovarian yolk sac tumor [3]
- They can be associated with prominent signal voids on MRI
- Areas of haemorrhage can also be seen
References
- ↑ 1.0 1.1 Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015
- ↑ 2.0 2.1 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015
- ↑ 3.0 3.1 Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015
- ↑ Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015