Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Abdom Radiol (NY). 2023 May;48(5):1694-1708. doi: 10.1007/s00261-022-03768-y. Epub 2022 Dec 20.
Adnexal masses during pregnancy are a relatively uncommon entity. Their clinical management is challenging given the overlapping features of certain entities on imaging and histopathology, which can mimic malignancy, and the potential side effects to the mother and fetus, whether expectant management versus surgery is pursued. Ultrasonography with Doppler evaluation is the modality of choice for evaluating adnexal masses during pregnancy. Magnetic resonance imaging is the second-line modality useful when US findings are inconclusive/indeterminate. Most adnexal masses in pregnant patients are benign in origin (e.g., functional cysts, mature cystic teratoma, decidualization of endometrioma), but a few are malignant in origin (e.g., dysgerminoma, granulosa cell tumor). Most cases of adnexal masses are asymptomatic, but complications such as ovarian torsion can occur. This review aims to familiarize the radiologist with the imaging of adnexal lesions during pregnancy so that the radiologist can identify ovarian cancer. Specifically, the review will detail the most common benign and malignant adnexal masses in pregnancy, mimickers, and their corresponding imaging findings on US and MRI.
怀孕期间的附件肿块是一种相对少见的病症。由于某些实体在影像学和组织病理学上具有重叠特征，可能模拟恶性肿瘤，以及无论采用期待治疗还是手术治疗，对母亲和胎儿都可能产生潜在的副作用，因此其临床管理具有挑战性。超声检查联合多普勒评估是评估怀孕期间附件肿块的首选方式。当超声检查结果不确定/不明确时，磁共振成像（MRI）是二线检查方式。大多数孕妇附件肿块为良性起源（例如功能性囊肿、成熟囊性畸胎瘤、子宫内膜异位瘤的蜕膜化），但少数为恶性起源（例如无性细胞瘤、颗粒细胞瘤）。大多数附件肿块病例是无症状的，但也可能发生并发症，如卵巢扭转。本综述旨在使放射科医生熟悉怀孕期间附件病变的影像学表现，以便放射科医生能够识别卵巢癌。具体来说，该综述将详细介绍怀孕期间最常见的良性和恶性附件肿块、类似物及其在超声和 MRI 上的相应影像学表现。
