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Il Giornale Italiano di Radiologia Medica 2018 Settembre-Ottobre;5(5):684-94

DOI: 10.23736/S2283-8376.18.00121-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

ADNEX Magnetic Resonance Score for the characterization of indeterminate adnexal lesions at ultrasound examination in the era of IOTA Score (International Ovarian Tumor analysis)

Francesca ROSA 1 , Giulia PERUGIN 1, Daria SCHETTINI 2, Guglielmo AZIONI 3, Silvia ROMEO 1, Daniele MORCALDI 2, Nicoletta GANDOLFO 2

1 Dipartimento di Scienze della Salute (DISSAL), Università di Genova, Genova, Italia; 2 SC Radiologia, Dipartimento di Diagnostica per immagini, Ospedale di Villa Scassi ASL 3, Genova, Italia; 3 SC Ostetricia e Ginecologia, Dipartimento di Specialità Chirurgiche, Ospedale di Villa Scassi ASL 3, Genova, Italia


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To describe the advantages of the application of the ADNEX-RM Score for the characterization of indeterminate adnexal lesions at ultrasonographic examination. Ultrasound examination represents the first level technique for detection and characterization of adnexal lesions. Gynecologists commonly use the qualitative classification, validate by the IOTA group, to discriminate benign/malignant mass using 5 categories. Magnetic resonance imaging (MRI) is considered a second level technique for indeterminate lesions at US examination. ADNEX-RM Score puts together all the multiparametric information provided by the MRI and correlates with the crescent malignancy risk with a score from 1 to 5. As other score (such as BIRADs), ADNEX-RM Score incorporates both anatomical and functional MR sequences to evaluate the likelihood of benignity/malignancy of an adnexal mass. The score ranges from 1 (no ovarian mass) to 5 (probably malignant mass) and depends on lesion composition (fat, fluid, hemorrhagic content), morphological features (septations, solid papillary projections, solid component), signal on T2- and diffusion weighted images and on perfusion curves with a high sensibility (92%) and specificity (85%). Standardized MRI protocols and ADNEX-MR Score application allow an accurate characterization of adnexal lesions (also for non-dedicated radiologists) and provide, also, a standardized terminology which can help radiologists relay to the clinician the likelihood of benignity or malignancy.


KEY WORDS: Ovarian neoplasms - Magnetic resonance imaging - Tomogaphy

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