Henz Concatto Natália, Ayadi Salma, Giovanaz Ariane, Braga Visconti Camila, Uzan Catherine, Akakpo Jean-Paul, Canlorbe Geoffroy, Badachi Yasmina, Lucidarme Olivier
Radiology Department, Abdominal Imaging, Hospital Moinhos de Vento, Porto Alegre, Brazil.
Specialised and Emergency Imaging Department, Pitié-Salpêtrière Hospital, Paris, France.
Abdom Radiol (NY). 2025 May 14. doi: 10.1007/s00261-025-04978-w.
Bilateral adnexal lesions involve structures such as the ovaries, fallopian tubes, and surrounding tissues, arising from diverse etiologies, including inflammatory, infectious, neoplastic, and functional causes. Their variable presentation poses a diagnostic challenge in clinical practice, necessitating a multidisciplinary approach for accurate assessment and management. The American College of Radiology (ACR) introduced the Ovarian-Adnexal Reporting and Data System (O-RADS) as a standardized lexicon and risk stratification tool for evaluating adnexal lesions via ultrasound (US) and magnetic resonance imaging (MRI). While MRI is the most accurate modality for assessing indeterminate adnexal masses, bilateral lesions frequently present diagnostic dilemmas, particularly when they exhibit divergent O-RADS classifications or arise from different etiologies. The O-RADS system does not provide specific guidelines for bilateral lesions, requiring independent classification of each lesion, with management dictated by the highest assigned category. Certain pathologies demonstrate a propensity for bilateral involvement, underscoring the importance of recognizing their imaging characteristics and differential diagnoses. Integrating this knowledge into diagnostic reports enhances clinical decision-making and optimizes patient outcomes.
双侧附件病变累及卵巢、输卵管及周围组织等结构，病因多样，包括炎症、感染、肿瘤及功能性病因。其表现各异，给临床诊断带来挑战，因此需要多学科方法进行准确评估和管理。美国放射学会（ACR）推出了卵巢-附件报告和数据系统（O-RADS），作为通过超声（US）和磁共振成像（MRI）评估附件病变的标准化词汇表和风险分层工具。虽然MRI是评估不确定附件肿块最准确的检查方式，但双侧病变常带来诊断难题，尤其是当它们表现出不同的O-RADS分类或源于不同病因时。O-RADS系统未为双侧病变提供具体指南，需要对每个病变进行独立分类，管理方式由最高指定类别决定。某些病理情况显示出双侧受累的倾向，这凸显了认识其影像学特征和鉴别诊断的重要性。将这些知识整合到诊断报告中可增强临床决策并优化患者预后。
