Non-dynamic contrast enhancement at 30-40 seconds post-injectionĮnhancement of the solid tissue within the adnexal lesion (blue arrow) is hypoenhancing to the outer myometrium (orange arrow) at 30-40 seconds post-contrast injectionĮnhancement of the solid tissue within the adnexal lesion (blue arrow) is equal to or greater than the outer myometrium (orange arrow) at 30-40 seconds post-contrast injection Solid tissue shows minimal and gradual increase in enhancement over time with no well-defined shoulder and no plateauĮnhancement of the solid tissue within the adnexal lesion with an initial slope less than the myometrium, moderate increase in signal intensity with a plateauĮnhancement of the solid tissue within the adnexal lesion with an initial slope greater than the myometrium, marked increase in signal intensity with a plateauĦb. Dynamic contrast enhancement with time intensity curves Other components of a dermoid not considered solid tissueĦa. Hair, calcification, and a Rokitansky nodule Lipid-containing material that does not enhance Solid-appearing material within a cyst that does not enhance (solid tissue enhances and conforms to one of the listed morphologies)Įnhancing solid component arising from the inner/outer wall or septation of an adnexal lesion, with a branching architectureĮnhancing solid component, measuring ≥ 3 mm, arising from the wall or septation of an adnexal lesion, with nodular appearanceĮnhancing linear strand that runs from one internal surface of the cyst to the contralateral side demonstrating an uneven margin (blue arrow)Įnhancing component of an adnexal lesion that does not fit into the categories of papillary projection, mural nodule, or irregular septation/wall (orange arrow)Įnhancing cyst wall demonstrating an uneven marginĮven contour or margin with no irregularities, mural nodules or papillary projectionsīlood, clot, non-enhancing debris and fibrin strands Hyperintense on T2WI and hyperintense on T1WI, and loses signal on fat saturated images Signal intensity ≥ iliopsoas muscle but < fatĪdnexal lesion with signal similar to urine or cerebral spinal fluidĪdnexal lesion with signal clearly higher than urine or CSFįluid content that follows CSF or urine on all sequences: hyperintense on T2WI and hypointense on T1W1Īppearance when the non-dependent fluid component has a different signal intensity from the dependent fluid component with horizontal delineation (blue arrow)Ĭontent is hypointense on T2WI and hyperintense on T1WIĬyst fluid that is hypointense on T2WI the extent of hypointense T2 signal intensity may be homogenous, variable within the cyst or graduated and dependentĬontent is variable on T2WI and variably hypointense on T1WI Signal intensity between that of iliopsoas muscle and CSF Uneven margin of a solid lesion or solid tissue Regular or even margin of a solid lesion or solid tissue Shape or Contour of Solid Lesion or Solid Tissue Largest diameter of the lesion and/or solid component in any imaging plane.ģ. Other solid components, not considered solid tissue More than one locule, with or without solid tissue.Ĭonforms to one of the following morphologies and enhances: papillary formations, mural nodules, irregular cyst wall/septations, and solid portion. Single locule, without or without solid tissue. A follicle is hyperintense on T2WI, hypointense on T1WI, and does not enhance.Ĭyst ≤ 3 cm with an enhancing crenulated wall on subtracted post-contrast T1WI, +/- blood flow or hemorrhagic contents. Simple cyst ≤ 3 cm in pre-menopausal women.

(consistent with normal ovarian physiology) Risk Stratification System hyperlink: September-2020.pdf Non-DCE: Hyperenhancing to myometrium at 30-40s Non-DCE: Hypo/isoenhancing to myometrium at 30-40s

Proteinaceous, hemorrhagic, or mucinous fluidĮnhancing solid tissue (papillary projection, mural nodule, irregular septation/wall, larger solid portions) NOT follicle or corpus luteum or hemorrhagic cyst <3cm in premenopausal women NO peritoneal nodularity or irregular thickeningįollicle or corpus luteum or hemorrhagic cyst <3cm in premenopausal women Peritoneal nodularity or irregular thickening

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