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Adnexal masses pose a diagnostic dilemma to the gynaecologist as well as radiologist because of their varied spectrum. The most important thing that needs to be determined is that whether the lesion is benign or malignant, so that the patient gets the appropriate treatment based on the pathology. Hence, the aim of the present study was to determine the accuracy of MRI in diagnosing benign and malignant adnexal lesions and its correlation with histopathological findings. Materials and Methods: The present study was a prospective cross-sectional study which was conducted in the Department of Imaging and interventional Radiology of Meenakshi Mission Hospital and Research Centre, Madurai. Patients presented with history and clinical symptoms of adnexal tumours and patients with ultrasonography (USG) detected indeterminate adnexal masses were included in the study. Results: In this study, the accuracy of MRI was about 93% in identifying the benign and malignant lesions. The cystic characterization of lesion was detected in majority of the subjects 60 (66.7%) with the help of MRI compared to USG, where only 30 (33.3%) of the subjects were identified. The solid lesions were also better identified with the help of MRI i.e. 19(21.1%) cases, compared to USG in which 13(14.4%) cases were only assessed. Conclusion: In the present study, MRI was found to be highly specific (95%) and accurate (93%) in diagnosis of benign and malignant lesions.

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