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

It is difficult to distinguish subtypes of ovarian germ cell tumor on MRI alone. The majority of ovarian germ cell tumors have a solid and cystic appearance with areas of hemorrhage and necrosis. On MRI, ovarian germ cell tumors may be characterized by T2: the septae are often hypointense or isointense T1 C+ (Gd): the septae often show marked enhancement (dysgerminoma), the presence of a prominent solid component containing calcifications and small foci of fat (mature teratoma), areas of haemorrhage can also be seen (yolk sac tumor).[1][2][3]

Pelvic MRI

Dysgerminomas [1]

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

Mature (cystic) ovarian teratoma[2]

  • 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[4]

  • 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 [3]

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

References

  1. ↑ 1.0 1.1 Ovarian dysgerminoma. http://radiopaedia.org/articles/ovarian-dysgerminoma. URL Accessed on November 11, 2015
  2. ↑ 2.0 2.1 Mature (cystic) ovarian teratoma. http://radiopaedia.org/articles/mature-cystic-ovarian-teratoma. URL Accessed on November 11, 2015
  3. ↑ 3.0 3.1 Ovarian yolk sac tumour. http://radiopaedia.org/articles/ovarian-yolk-sac-tumour. URL Accessed on November 11, 2015
  4. ↑ Immature ovarian teratoma. http://radiopaedia.org/articles/immature-ovarian-teratoma. URL Accessed on November 11, 2015

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