Chandramohan Anuradha, Bhat Tameem Ahmed, John Reetu, Simon Betty
Department of Radiology, Christian Medical College, Vellore, India.
Br J Radiol. 2020 Dec 1;93(1116):20200489. doi: 10.1259/bjr.20200489. Epub 2020 Sep 4.
Complex pelvic lesions can originate from various anatomical structures in the pelvis and pose a diagnostic dilemma due to a wide range of possible diagnoses. Accurate characterisation of these lesions would often require an algorithmic approach, which incorporates clinical findings, sequential use of multiple imaging modalities and a multiparametric approach. This approach usually aims at identifying key imaging features, which aid in anatomical localisation, morphology and tissue characterisation. There have been various attempts to standardise the lexicon used for describing adnexal masses in female patients; stratify their risk of cancer and suggest appropriate next steps in the management pathway. Through this review, we extend this approach to complex pelvic masses in female pelvis in general and will focus on optimal use of different imaging modalities to arrive at definitive diagnosis or meaningful differential diagnosis. We will also discuss potential pitfalls of imaging diagnosis and common mimics.
复杂的盆腔病变可起源于盆腔内的各种解剖结构，由于可能的诊断范围广泛，会造成诊断上的两难困境。准确描述这些病变通常需要一种算法方法，该方法结合临床发现、多种成像模态的序贯使用以及多参数方法。这种方法通常旨在识别关键的成像特征，这些特征有助于进行解剖定位、形态学分析和组织特征描述。已经有各种尝试来规范用于描述女性患者附件肿块的术语；对其癌症风险进行分层，并提出管理路径中的适当后续步骤。通过本综述，我们将这种方法推广到一般女性盆腔中的复杂盆腔肿块，并将重点关注不同成像模态的最佳使用，以得出明确诊断或有意义的鉴别诊断。我们还将讨论成像诊断的潜在陷阱和常见的类似病变。
