Ovarian cancer MRI
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] Huda A. Karman, M.D.
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Overview
MRI
Endometrioid carcinoma of the ovary Pelvic MRI: Reported signal characteristics include
- T2:
- Relatively low signal intensity of the tumor wall
- Shading sign may be seen
- T1C+(Gd):
- can show mild enhancement
Ovarian serous cystadenocarcinoma
- MRI is the modality of choice in the characterization of ovarian malignancy and in the detection of lymphatic, peritoneal, and distant metastases
- Both for preoperative planning and post-treatment follow up.
- The cystic components
- Are high T2, low T1 signal
- If there has been intralesional hemorrhage (c.f. mucinous cystadenocarcinoma, there is typically slightly increased T1 signal of the cystic component)
- Solid malignant components
- Demonstrate intermediate T1 and T2 signal, restricted diffusion, and gadolinium enhancement.
- DWI is useful for the detection of distant metastases.
Ovarian mucinous cystadenocarcinoma
- T1:
- The signal intensity of mucin on T1-weighted images varies depending on the degree of mucin concentration
- On T1-weighted images, loculi with watery mucin have a lower signal intensity than loculi with thicker mucin.
- T2
- on T2-weighted images, the corresponding signal intensities are flipped, so that loculi with watery mucin have a high signal intensity and loculi with thicker mucin appear slightly hypointense.
- MRI
- Often seen as a cystic ovarian mass with the margin being generally smooth. Solid protrusions are often both round and few in number.
- Reported signal characteristics include:
- T1: can vary from low to very high (often dependent on the hemorrhagic component(s), not a specific feature)