Ovarian germ cell tumor MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Overview

Pelvic MRI may be diagnostic of ovarian germ cell tumor.

Pelvic MRI

Dysgerminomas

• tumors are often seen divided into lobules by septa
• Reported signal characteristics include:
• T2: the septae are often hypointense or isointense 3 T1 C+ (Gd): the septae often show marked enhancement

Mature (cystic) ovarian teratoma

• MR evaluation usually tends to be reserved for difficult cases, but is exquisitely sensitive to fat components
• Both fat suppression techniques and chemical shift artefact can be used to confirm the presence of fat
• Enhancement is also able to identify solid invasive components, and as such can be used to accurately locally stage malignant variants

Immature ovarian teratoma

• The presence of a prominent solid component containing calcifications and small foci of fat is suggestive. Cystic components may contain serous, mucinous, or fatty sebaceous material
• Haemorrhage may be present

Ovarian yolk sac tumor

• They can be associated with prominent signal voids on MRI
• Areas of haemorrhage can also be seen

Ovarian choriocarcinoma

• On imaging, choriocarcinomas appear as vascular solid tumors with cystic, haemorrhagic, and necrotic areas