title: MR imaging of ovarian masses: classification and differential diagnosis.
abstract: OBJECTIVE
  We propose a Magnetic Resonance Imaging (MRI) guided approach to differential diagnosis of ovarian tumours based on morphological appearance.
  
  
  BACKGROUND
  Characterization of ovarian lesions is of great importance in order to plan adequate therapeutic procedures, and may influence patient's management. Optimal assessment of adnexal masses requires a multidisciplinary approach, based on physical examination, laboratory tests and imaging techniques. Primary ovarian tumours can be classified into three main categories according to tumour origin: epithelial, germ cell and sex cord-stromal tumours. Ovarian neoplasms may be benign, borderline or malignant. Using an imaging-guided approach based on morphological appearance, we classified adnexal masses into four main groups: unilocular cyst, multilocular cyst, cystic and solid, predominantly solid. We describe MR signal intensity features and enhancement behaviour of ovarian lesions using pathologically proven examples from our institution.
  
  
  CONCLUSIONS
  MRI is an essential problem-solving tool to determine the site of origin of a pelvic mass, to characterize an adnexal mass, and to detect local invasion. The main advantages of MRI are the high contrast resolution and lack of ionizing radiation exposure. Although different pathological conditions may show similar radiologic manifestations, radiologists should be aware of MRI features of ovarian lesions that may orientate differential diagnosis.
  
  
  CONCLUSIONS
  • Diagnostic imaging plays a crucial role in detection, characterization and staging of adnexal masses. • Characterization of an ovarian lesion may influence patient's management. • Different pathological conditions may have similar radiologic manifestations. • Non-neoplastic lesions should always be taken into consideration.
authors.affiliation: Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy. pietrofoti@hotmail.com.
authors.forename: Pietro Valerio
authors.initials: PV
authors.lastname: Foti
authors.affiliation: Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Attinà
authors.affiliation: Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy.
authors.forename: Saveria
authors.initials: S
authors.lastname: Spadola
authors.affiliation: Department G.F. Ingrassia - Institute of Pathology, University of Catania, Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.affiliation: Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Farina
authors.affiliation: Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Palmucci
authors.affiliation: Department of General Surgery and Medical-Surgical Specialties - Institute of Obstetrics and Ginecology, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zarbo
authors.affiliation: Department of General Surgery and Medical-Surgical Specialties - Institute of Obstetrics and Ginecology, University of Catania, Catania, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Zarbo
authors.affiliation: Pathology Unit, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: D'Arrigo
authors.affiliation: Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Milone
authors.affiliation: Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico-Vittorio Emanuele", Via Santa Sofia 78, 95123, Catania, Italy.
authors.forename: Giovanni Carlo
authors.initials: GC
authors.lastname: Ettorre
keywords: Magnetic resonance imaging; Ovarian cancer; Ovary; TNM staging; Tumour staging