MRI of Tumors and Tumor Mimics in the Female Pelvis: Anatomic Pelvic Space–based Approach

Nougaret, Stéphanie; Nikolovski, Ines; Paroder, Viktoriya; Vargas, Hebert Alberto; Sala, Evis; Carrère, Sébastien; Tétreau, Raphaël; Hoeffel, Christine; Forstner, Rosemarie; Lakhman, Yulia

doi:10.1148/rg.2019180173

Cited by 36 publications

(33 citation statements)

References 76 publications

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“…In cases of masses abutting the ovary, multiple imaging signs help to assess the origin of the mass. Signs suggestive of ovarian origin include a “beak” sign, which is a sharp angle between the ovary and the mass, forming a beak shape at the edge of the ovary; the “ovarian vascular pedicle” sign, which is a depiction of a direct joining of the normal or asymmetrically enlarged gonadal vein to the mass; the “phantom organ sign”, which is an undetectable ovary provided that there is no history of surgical resection or transposition; and the “embedded organ sign”, which is when the ovary appears embedded in the mass [ 3 , 8 , 9 ]. On the other hand, there are signs suggestive of extra-ovarian origin, such as the “claw sign” and the “bridging vessel” sign, that indicate a uterine origin of the mass, which will be described in detail later, following the paraovarian cyst ( Section 5.1.5 ) and leiomyoma ( Section 5.2.2 ) sections, respectively.…”

Section: Is the Mass Ovarian Or Extra-ovarian In Origin?mentioning

confidence: 99%

“…However, 5.1% of pelvic masses mimicking ovarian cancer are found to be an extra-ovarian disease [ 2 ]. Given that malignant and non-malignant processes share non-specific clinical symptoms, such as vague abdominal pain, abdominal and pelvic mass, weight loss, or vaginal hemorrhage, imaging plays a pivotal role in characterizing these lesions and assessing their origins [ 3 ]. Ultrasound is usually the primary modality in assessing a pelvic mass and MRI is the modality of choice for further characterization given its superior spatial resolution and soft tissue contrast [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Mimics and Pitfalls of Primary Ovarian Malignancy Imaging

et al. 2022

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The complex anatomy and similarity of imaging features of various pathologies in the pelvis can make accurate radiology interpretation difficult. While prompt recognition of ovarian cancer remains essential, awareness of processes that mimic ovarian tumors can avoid potential misdiagnosis and unnecessary surgery. This article details the female pelvic anatomy and highlights relevant imaging features that mimic extra-ovarian tumors, to help the radiologists accurately build a differential diagnosis of a lesion occupying the adnexa.

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Section: Is the Mass Ovarian Or Extra-ovarian In Origin?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mimics and Pitfalls of Primary Ovarian Malignancy Imaging

et al. 2022

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“…With the continuous advancement and development of imaging technology, transvaginal color Doppler ultrasound (TVCDU) has seen an increased and more widespread use in the diagnosis of pelvic tumors. Compared with transabdominal ultrasound, the probe resolution of TVCDU is higher, and the diagnosis of the lesions and blood flow of the internal organs of the pelvis is easier, as well as no need to hold the urine (6). In this study, the reliability of TVCDU for identifying benign and malignant pelvic tumors in women of childbearing age was evaluated.…”

Section: Introductionmentioning

confidence: 99%

Reliability of the application of transvaginal color Doppler ultrasound in the identification of pelvic tumors in women of childbearing age

Zhi

Wang

et al. 2020

Ann Transl Med

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Background: Recently, transvaginal color Doppler ultrasound (TVCDU) has been widely used in the diagnosis of pelvic tumors. This study aimed to assess the reliability of the application of TVCDU in the identification of pelvic tumors in women of childbearing age. Methods:The clinical data of 209 patients with pelvic tumors at childbearing age admitted to our hospital from January 2016 to December 2019 were retrospectively analyzed. The ultrasound signs, color Doppler ultrasound score (CDUS), and resistance index (RI) of benign and malignant pelvic tumors diagnosed by TVCDU were analyzed. The value of transabdominal color Doppler ultrasound (TACDU) and TVCDU in the diagnosis of benign and malignant pelvic tumors was calculated.Results: There were 150 cases with benign pelvic tumors and 59 cases with malignant tumors. Most benign tumors had an intact capsule and regular shape, were mainly cystic, and were rarely accompanied by ascites; meanwhile, malignant tumors were mostly non-capsular and irregular in shape, mainly solid or cystic, and were often accompanied by ascites. There were significant differences in the above-mentioned ultrasound signs between benign and malignant tumors (P<0.05). The CDUS score of benign pelvic tumors was significantly lower than that of malignant tumors, and the RI value was significantly higher than that of the malignant tumors (P<0.05). The sensitivity, specificity, and accuracy of TACDU in the diagnosis of benign pelvic and malignant tumors were 83.33%, 84.75%, and 83.73%, respectively; and the sensitivity, specificity, and the accuracy of TVCDU in the diagnosis of benign pelvic and malignant tumors were 95.33%, 88.14%, and 93.30%, respectively; thus TVCDU had a superior performance compared to TACDU, especially in sensitivity and accuracy (P<0.05). Conclusions:The sensitivity and accuracy of TVCDU in the differential diagnosis of benign pelvic and malignant tumors in women at childbearing age were significantly higher than those of TACDU. The combined application of CDUS and RI can further improve the accuracy in the diagnosis of pelvic tumors.

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“…En resonancia magnética, la mucina de los implantes peritoneales tiene baja señal en T1 y alta en T2. 6 Se pueden observar implantes adyacentes a asas intestinales que condicionan oclusión. Los ovarios pueden tener metástasis quísticas complejas.…”

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“…El signo de festoneado y asas intestinales centralizadas o envueltas ayudan a diferenciar de una ascitis loculada. 5,6 A B Figura 1:…”

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