Fig. 2

Female patient, 17-year-old virgin, complaining of lower abdominal pain and progressive abdominal enlargement.US showed left adnexal complex cystic mass with solid component inside. a–d Conventional MRI images showed presence of large complex pelvi-abdominal adnexal mass. It measures 5 × 8 × 5.5 cm AP, C.C, and TS respectively. It elicited a hypo-intense signal in T1WI and hyper-intense signal in T2WI of its cystic component, while the solid component inside shows areas of bright signal in T1WI and intermediate signal in T1WI suppressed on fat suppression. No solid enhancing masses seen on post contrast. e Proton MRS (TR = 1300 m sec, TE = 144 m sec) observed a sharp lipid peak around1.3 ppm in the solid component of the mass (high lipid content). Conventional MRI-based diagnosis: The patient was diagnosed as having benign complex left adnexal mass likely ovarian, mature cystic teratoma is highly considered; MRS diagnosis: Confirmed the benign nature of the mass with Cho/Cr ratio 0.29; Pathological diagnosis: Mature cystic teratoma