Pitfalls in Imaging of Female Pelvic Masses
DOI: 10.1007/s40134-017-0245-5 Mariana Horta Teresa Margarida Cunha
Purpose of Review
The purpose of this review is to highlight potential magnetic resonance (MR) imaging pitfalls that may mask and simulate ovarian cancer.
MR imaging is the standard method for evaluating female pelvic masses of indeterminate origin, especially sonographically indeterminate adnexal masses. To define the correct origin and nature of a pelvic mass has an enormous clinical impact, namely in females of child-bearing age. This is particularly true in adnexal lesions. Ovarian cancer usually requires a cytoreductive surgery in a specialized oncological centre. In contrast, a benign ovarian lesion may be treated by simple resection in a general hospital. To help preventing diagnostic errors and in order to guide appropriate therapeutic management, radiologists should be aware of potential MR pitfalls that may mask and simulate ovarian cancer.
The first section of this article will describe the MR imaging protocol that authors perform in their oncological centre, highlighting how imaging techniques can be optimized in order to reduce pitfalls in the characterization of an indeterminate pelvic mass. In the next section, authors will revise the main anatomic and organ-specific signs that may allow the radiologist to determine the ovarian origin of a pelvic mass. Finally, benign gynaecological masses that may simulate ovarian cancer in a non-emergency setting will be discussed, with emphasis on features that may provide important clues to their diagnosis. Keywords Ovarian cancer. Benign ovarian tumours. Magnetic resonance imaging. Female pelvic masses. Indeterminate adnexal masses. Pitfalls in gynaecological imaging.