Ovarian cancer MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

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Endometrioid carcinoma of the ovary

Pelvic MRI

Reported signal characteristics include

T2: relatively low signal intensity of the tumour wall a shading sign may be seen

T1 C + (Gd): can show mild enhancement

Ovarian serous cystadenocarcinoma


MRI is the modality of choice in the characterisation of ovarian malignancy and in the detection of lymphatic, peritoneal, and distant metastases, both for preoperative planning and post treatment follow up.

The cystic components are high T2, low T1 signal, unless there has been intralesional haemorrage (c.f. mucinous cystadenocarcinoma, where there is typically slightly increased T1 signal of the cystic component)

Solid malignant components demonstrate intermediate T1 and T2 signal, restricted diffusion, and gadolinium enhancement.

DWI is useful for detection of distant metastases.

MRI Ovarian mucinous cystadenocarcinoma T1 the signal intensity of mucin on T1-weighted images varies depending on the degree of mucin concentration on T1-weighted images, loculi with watery mucin have a lower signal intensity than loculi with thicker mucin.

T2 on T2-weighted images, the corresponding signal intensities are flipped, so that loculi with watery mucin have high signal intensity and loculi with thicker mucin appear slightly hypointense.


Often seen as a cystic ovarian mass with the margin being generally smooth. Solid protrusions are often both round and few in number.

Reported signal characteristics include

T1: can vary from low to very high (often dependent on haemorrhagic component(s), not a specific feature)