MR features of fluid-fluid levels in ovarian masses

Abstract

To evaluate retrospectively the frequency and imaging features of fluid-fluid levels (FFLs) in pathologically proven ovarian masses on magnetic resonance (MR) images. The authors reviewed the preoperative MR findings of 556 ovarian masses in 428 patients. Presence, numbers, and signal intensities (SI) of FFLs were analyzed. In non-teratomas, we assessed whether SI of the FFLs of benign masses and malignant neoplasms differed using the chi(2) test. FFLs were observed in 66 of 556 ovarian masses (11.9%) on MR images, fat-fluid levels were observed in 11 of 80 teratomas, and FFLs attributed to hemorrhage in 54 of 476 non-teratomas and one twisted teratoma. Non-neoplastic cystic lesions were most common non-teratomas to contain FFLs (27/197, 13.7%), followed by malignant neoplasms (23/177, 13.0%). Benign neoplasms rarely contained FFLs (4/102, 3.9%); those that did were commonly associated with complications such as torsion or inflammation. A hypointense supernatant layer together with a hyperintense dependent layer on T1-weighted images (T1WIs) was significantly more common in malignant neoplasms than in benign masses (P < 0.0001). FFLs occurred in various ovarian masses ranging from benign to malignant neoplasms on MR images. In non-teratomas, a hypointense supernatant layer and a hyperintense dependent layer on T1WIs may favor a diagnosis of malignancy.

Fluid Levels in Pediatric Imaging: A Pictorial Review

“…Different stages of hemorrhage may be delineated with fluid levels on CT of a subdural hematoma. An MRI brings more sensitivity to tissue contrast compared with ultrasound and CT (different signal intensities of acute or chronic hemorrhage, slow flowing blood) [3]. A lipohemarthrosis level means communication between marrow space and the joint space in skeletal trauma.…”

Teratoma quístico de ovario con múltiples glóbulos flotantes intraquísticos

“…Aunque se ha mencionado que un nivel líquidolíquido de una tumoración ovárica sugiere la posibilidad de un teratoma quístico, otros tumores ováricos quísticos, incluyendo endometrioma y quistes ováricos hemorrágicos, también pueden contener elementos sanguíneos en varios estadios de degeneración y mostrar nivel líquidolíquido. Además, los hallazgos de estos niveles pueden ser no siempre suficientes para el diagnóstico del teratoma quístico de ovario(8) .…”