Fig. 3

Female patient, 58 years old, presented with lower abdominal pain.US showed right adnexal cystic mass, multilocular with septations. a–c Conventional MRI images showed a large right adnexal multilocular cystic mass with thick wall and septations; it measures 9.5 × 10 × 7.5 cm AP, C.C, and TS respectively. It shows hypo-intense signal in T1WI and hyper-intense signal in T2WI, with enhanced wall and septae on post-contrast image. d Proton MRS (TE = 288 m sec) observed a sharp lipid and creatine peaks around 1.3 ppm and 3 ppm respectively, another small choline peak is observed around 3.2 ppm. Conventional MRI-based diagnosis: borderline ovarian tumor; MRS diagnosis: confirmed the benign nature of the lesion with Cho/Cr ratio 0.45; Pathological diagnosis: benign serous cyst adenoma