Fig. 1
From: Functional MRI in the pre-operative assessment of GI-RADS 3, 4, and 5 ovarian masses
A 42-year-old-female presented with menstrual irregularity, and pelvic discomfort. US revealed left small multi-locular predominantly cystic lesion with internal septations and solid component (GI-RADS 4). CA-125 was normal. a–d Conventional MRI. a–c coronal T2, axial T2, and axial T1-weighted images show left multi-locular predominantly cystic adnexal lesion ( 6 cm), it elicits mixed (intermediate/hyperintense) T2 signal and low T1 signal, it shows multiple internal septations and solid components which show avid enhancement in the post contrast series (d). Conventional MRI: Findings are suggestive of a borderline ovarian tumor. e, f Diffusion WI and ADC map demonstrate diffusion restriction of the solid component of the solid with estimated ADC value measures 0.74 × 10−3 mm2/s. g DCE with color mapping shows type I curve: slowly rising curve. MRE%, 6%; Tmax, 197.7 s; WIR, 4. h, i Proton MRS at intermediate TE (144 ms): The spectrum shows high choline peak of its solid components, high NAA peak, and small lipid and lactate peaks. Cho/Cr, 1.5. Multiparametric MRI diagnosis: Findings are suggestive of a left borderline ovarian lesion by conventional MRI, DWIs, and benign curve on DCE-MRI. Operative details: Left salpingo-oophorectomy. i H&E stain with original magnification power 25 revealed a cyst with a fibrous wall, lined by a single layer of bland-looking serous cells. Final pathological diagnosis: Left serous cystadenoma (benign epithelial tumors)