Ovarian germ cell tumor MRI: Difference between revisions
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* It can also mimic the appearance of epithelaial ovarain neoplasms: | * It can also mimic the appearance of epithelaial ovarain neoplasms: | ||
** Multilobular mass with cysts, papillary projections and irregular septations | ** Multilobular mass with cysts, papillary projections and irregular septations | ||
''' | '''Yolk sac tumor''' | ||
* The bright dot sign (enhancing foci in the wall or solid component) is the common finding, although it is not the pathognomonic finding for the yolk sac tumor.<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref> | * The bright dot sign (enhancing foci in the wall or solid component) is the common finding, although it is not the pathognomonic finding for the yolk sac tumor.<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref> | ||
* Capsular tear is another common finding which is not the pathognomonic finding for the yolk sac tumor. | * Capsular tear is another common finding which is not the pathognomonic finding for the yolk sac tumor. | ||
* Areas of hemorrhage with high signal intensity on T1 images can also be observed. | * Areas of hemorrhage with high signal intensity on T1 images can also be observed. | ||
'''Embryonal tumor''' | |||
* The tumor is large, predominantly solid and unilateral with areas of necrosis and hemorrhage.<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref> | |||
* There may be cystic areas that contains mucoid material. | |||
'''Choriocarcinoma''' | |||
* Highly vascularized solid mass<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref> | |||
* Vascular component produces signals in T2 images. | |||
'''Mixed germ cell tumors''' | |||
* There is no specific imaging criteria for these tumors.<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref> | |||
* Imaging may vary according to the content of the tumors. | |||
* Finding associated with yolk sca tumor and dysgerminoma are more common. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 14:45, 6 March 2019
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American Roentgen Ray Society Images of Ovarian germ cell tumor MRI |
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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
There are no MRI findings associated with [disease name].
OR
[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with [disease name]. However, an MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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 hemorrhage can also be seen (yolk sac tumor).[1][2][3]
Pelvic MRI
Mature teratoma Pelvic MRI is sensitive in the diagnosis of mature teratoma. Findings on MRI suggestive of/diagnostic of mature teratoma include:[4]
- Fat
- Fat may be misdiagnosed with hemorrhage in the hemorrhagic cysts and it should be differentiated from that in three following ways:
- Chemical-shift artifact in the frequency-encoding direction
- Gradient-echo imaging with an echo time when water and fat are in the opposite state
- Sequences with frequency-selective fat saturation
- Fat may be misdiagnosed with hemorrhage in the hemorrhagic cysts and it should be differentiated from that in three following ways:
- Calcification
- Fat–fluid level
- Tuft\Hairs
- Palm tree-like protrusion
- Dermoid nipples (Rokitansky nodules)
Mondermal teratoma
- Struma ovarii:
- MR imaging findings may be more characteristics for the diagnosis and include:[5]
- Absence of fat
- Cystic spaces with both high and low signal intensity on T1 and T2 images
- Thick, gelatinous colloid of struma may be associated with a low-intensity signal on both T1 and T2 images.
- A multilocular mass with variable degree of signal intensity in T1 and T2 images in the locular spaces.
- MR imaging findings may be more characteristics for the diagnosis and include:[5]
- Carcinoid tumor:
- Absence of fat
- It should be distinguished from other solid malignancies.
Immature ovarian teratoma
- Foci of fat interspaced within solid the solid mass[6]
- Fatty liquid may be observed in cystic component
- Calcifications are small, irregular, and scattered through the tumor
Dysgerminomas
- Lobulated solid mass[6]
- Interspaced fibrovascular septa
- Septa, when edematous, are hyperintense on T2 images
- Low signal intensity compared to muscle on T1 image
- Isointense or slightly hyperintense on T2 image
- It can also mimic the appearance of epithelaial ovarain neoplasms:
- Multilobular mass with cysts, papillary projections and irregular septations
Yolk sac tumor
- The bright dot sign (enhancing foci in the wall or solid component) is the common finding, although it is not the pathognomonic finding for the yolk sac tumor.[6]
- Capsular tear is another common finding which is not the pathognomonic finding for the yolk sac tumor.
- Areas of hemorrhage with high signal intensity on T1 images can also be observed.
Embryonal tumor
- The tumor is large, predominantly solid and unilateral with areas of necrosis and hemorrhage.[7]
- There may be cystic areas that contains mucoid material.
Choriocarcinoma
- Highly vascularized solid mass[7]
- Vascular component produces signals in T2 images.
Mixed germ cell tumors
- There is no specific imaging criteria for these tumors.[7]
- Imaging may vary according to the content of the tumors.
- Finding associated with yolk sca tumor and dysgerminoma are more common.
References
- ↑ Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015
- ↑ Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015
- ↑ Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015
- ↑ Outwater EK, Siegelman ES, Hunt JL (2001). "Ovarian teratomas: tumor types and imaging characteristics". Radiographics. 21 (2): 475–90. doi:10.1148/radiographics.21.2.g01mr09475. PMID 11259710.
- ↑ Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
- ↑ 6.0 6.1 6.2 Shaaban, Akram M.; Rezvani, Maryam; Elsayes, Khaled M.; Baskin, Henry; Mourad, Amr; Foster, Bryan R.; Jarboe, Elke A.; Menias, Christine O. (2014). "Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features". RadioGraphics. 34 (3): 777–801. doi:10.1148/rg.343130067. ISSN 0271-5333.
- ↑ 7.0 7.1 7.2 Stein, Erica B.; Wasnik, Ashish P.; Sciallis, Andrew P.; Kamaya, Aya; Maturen, Katherine E. (2017). "MR Imaging–Pathologic Correlation in Ovarian Cancer". Magnetic Resonance Imaging Clinics of North America. 25 (3): 545–562. doi:10.1016/j.mric.2017.03.004. ISSN 1064-9689.