Assistante Publique des Hôpitaux de Paris, Department of Radiology Imaging and Interventional Radiology (IRIS), Tenon Hospital, APHP, Sorbonne University, 75005, Paris, Paris, France.
Saint-Antoine Research Cancer Center, Sorbonne University, Paris, France.
J Magn Reson Imaging. 2024 Mar;59(3):720-736. doi: 10.1002/jmri.28947. Epub 2023 Aug 7.
The ovarian-adnexal reporting and data system on magnetic resonance imaging (O-RADS MRI) score is now a well-established tool to characterize pelvic gynecological masses based on their likelihood of malignancy. The main added value of O-RADS MRI over O-RADS US is to correctly reclassify lesions that were considered suspicious on US as benign on MRI. The crucial issue when characterizing an adnexal mass is to determine the presence/absence of solid tissue and thus need to perform gadolinium injection. O-RADS MR score was built on a multivariate analysis and must be applied as a step-by-step analysis: 1) Is the mass an adnexal mass? 2) Is there an associated peritoneal carcinomatosis? 3) Is there any significant amount of fatty content? 4) Is there any wall enhancement? 5) Is there any internal enhancement? 6) When an internal enhancement is detected, does the internal enhancement correspond to solid tissue or not? 7) Is the solid tissue malignant? With its high value to distinguish benign from malignant adnexal masses and its high reproducibility, the O-RADS MRI score could be a valuable tool for timely referral of a patient to an expert center for the treatment of ovarian cancers. Finally, to make a precise diagnosis allowing optimal personalized treatment, the radiologist in gynecological imaging will combine the O-RADS MRI score with many other clinical, biological, and other MR criteria to suggest a pathological hypothesis. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
卵巢-附件磁共振成像报告和数据系统 (O-RADS MRI) 评分现已成为一种成熟的工具，可根据盆腔妇科肿块的恶性可能性对其进行特征描述。与 O-RADS US 相比，O-RADS MRI 的主要附加价值是正确地重新分类在 US 上被认为可疑的病变为 MRI 上良性的病变。描述附件肿块的关键问题是确定是否存在实性组织，因此需要进行钆造影剂注射。O-RADS MRI 评分是基于多变量分析构建的，必须作为逐步分析来应用：1）肿块是否为附件肿块？2）是否存在腹膜癌转移？3）是否有大量脂肪含量？4）是否有壁强化？5）是否有内部强化？6）当检测到内部强化时，内部强化是否对应于实性组织？7）实性组织是否为恶性？由于其对区分良性和恶性附件肿块具有很高的价值和很高的可重复性，O-RADS MRI 评分可能是及时将患者转诊至专家中心治疗卵巢癌的有价值的工具。最后，为了做出准确的诊断，从而实现最佳的个体化治疗，妇科影像学放射科医生将结合 O-RADS MRI 评分以及许多其他临床、生物学和其他磁共振标准，提出病理假说。证据水平：5 技术功效分期：3。
