Sadowski Elizabeth A, Stein Erica B, Thomassin-Naggara Isabelle, Rockall Andrea, Nougaret Stephanie, Reinhold Caroline, Maturen Katherine E
Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252.
Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
AJR Am J Roentgenol. 2023 Jan;220(1):6-15. doi: 10.2214/AJR.22.28084. Epub 2022 Aug 17.
The Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound (US) and MRI risk stratification systems were developed by an international group of experts in adnexal imaging to aid radiologists in assessing adnexal lesions. The goal of imaging is to appropriately triage patients with adnexal lesions. US is the first-line imaging modality for assessment, whereas MRI can be used as a problem-solving tool. Both US and MRI can accurately characterize benign lesions such as simple cysts, endometriomas, hemorrhagic cysts, and dermoid cysts, avoiding unnecessary or inappropriate surgery. In patients with a lesion that does not meet criteria for one of these benign diagnoses, MRI can further characterize the lesion with an improved specificity for cancer and the ability to provide a probable histologic subtype in the presence of certain MRI features. This allows personalized treatment, including avoiding overly extensive surgery or allowing fertility-sparing procedures for suspected benign, borderline, or low-grade tumors. When MRI findings indicate a risk of an invasive cancer, patients can be expeditiously referred to a gynecologic oncologic surgeon. This narrative review provides expert opinion on the utility of multiparametric MRI when using the O-RADS US and MRI management systems.
卵巢附件报告和数据系统（O-RADS）超声（US）和MRI风险分层系统由一组国际附件成像专家开发，旨在帮助放射科医生评估附件病变。成像的目的是对附件病变患者进行适当的分类。超声是评估的一线成像方式，而MRI可用作解决问题的工具。超声和MRI都可以准确地对良性病变进行特征性描述，如单纯囊肿、子宫内膜异位囊肿、出血性囊肿和皮样囊肿，避免不必要或不适当的手术。对于不符合这些良性诊断标准之一的病变患者，MRI可以进一步对病变进行特征性描述，提高对癌症的特异性，并在存在某些MRI特征时提供可能的组织学亚型。这使得能够进行个性化治疗，包括避免过度广泛的手术或对疑似良性、交界性或低级别肿瘤采用保留生育功能的手术。当MRI结果表明存在浸润性癌症风险时，患者可以迅速转诊至妇科肿瘤外科医生处。这篇叙述性综述就使用O-RADS超声和MRI管理系统时多参数MRI的效用提供了专家意见。
