الفهرس 
INTRODUCTION
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Imaging of ovarian masses includes evaluation by means of ultrasonography (US), computed tomography (CT), or magnetic resonance (MR) imaging. US is by far the most commonly used imaging modality for assessment of ovarian pathologic conditions. Endovaginal US has allowed markedly improved resolution for uterine and adnexal imaging and is essential for imaging adnexal masses whose nature is not apparent at transabdominal US.
MR imaging is better reserved for problem solving when US findings are non diagnostic or equivocal. MR imaging is most beneficial when a mass is very large, is located superiorly or laterally in the pelvis
The treatment of patients with ovarian masses requires initial stratification of
risk based on the imaging appearance of the mass, clinical presentation and findings, and serum CA- 125 level. Laparoscopic management of masses is largely restricted to those having a benign imaging appearance. Recommendations based on the US imaging appearance include no further evaluation (eg, simple cysts), follow-up US (eg, hemorrhagic cyst), MR imaging or laparoscopy (eg, suspected endometrioma, mature cystic teratoma,), or staging laparotomy (eg, cystic and solid masses). Morphologic analysis at US focuses on the presence of solid tissue, thick septations, ascites, fatty tissue, and papillary projections.
Factors such as larger size, small amounts of free fluid, bilaterality, and multilocularity are of lesser importance and are commonly seen in benign processes. Masses such as mature cystic teratomas, cysts, & endometriomas can be accurately diagnosed on the basis of findings at T1-weighted, T2-weighted, and fat-saturated T1- weighted MR imaging. Gadolinium-enhanced fatsaturated T1-weighted MR imaging of the entire abdomen is recommended to assess for peritoneal implants and to confirm the presence of solid components in the tumor. Endometriomas commonly demonstrate low signal intensity on T2- weighted images as well as implants and multiplicity. Fibrotic lesions such as cystadenofibromas also demonstrate low signal intensity on T2-weighted images.