1. Radiological imaging
of ovarian lesions.
Dr/ ABD ALLAH NAZEER. MD.

4. Congenital abnormality of the ovaries.

6. Abnormalities of the ovaries:
1- Agenesis or complete absence on one or both sides.
2- Gonadal dysgenesis (streak gonad) as in Turner
syndrome.
3- Duplicated ovary.
4- Failure of descent into the pelvis.
5- Ovotestis (true hermaphrodite) In which combined
ovarian and testicular tissues seen.
6- Adrenal or thyroid tissue on the ovary.

7. Pelvic inflammatory disease (PID) is a general term indicating
infection of the female upper genital tract and the surrounding
structures.It is a common and serious complication of sexually
transmitted disease. Acute episodes need appropriate care and
treatment; however, it is the long-term sequelae of chronic pelvic
pain, infertility, and ectopic pregnancy due to scarring and adhesions
that burden the healthcare system in an adverse manner.
It encompasses a broad category of diseases, including endometritis,
salpingitis, salpingo-oophoritis, tubo-ovarian abscess (TOA), and
pelvic peritonitis. The afflicted women may be asymptomatic, present
with mild nonspecific symptoms, or may have fulminant disease.
Prompt diagnosis and treatment of this condition are critical because
the complications of PID can be life and fertility threatening. The
varied clinical presentation and imaging findings may make it difficult
to diagnose PID, and sometimes it may remain undetected.
Pelvic Inflammatory Diseases.

8. Pelvic inflammatory disease. Left recurrent
tuboovarian abscess. Axial T2-weighted image (a)
shows a thick wall, complex, heterogeneously
hyperintense, fluid-containing adnexal mass, with
internal debris and gas bubbles, that represents the
most specific sign of an abscess. On axial T1-
weighted with fat suppression image (b) there is no
signs of hemorrhagic contents within the mass. The
sagittal T2-weighted image (c) demonstrates the
involvement of bowel loop characterized by the
thickening of the anterior rectal wall.

9. Loculated complex cystic lesion in the mid pelvis with folds
and thick wall enhancement suggestive of pyosalpinx.

10. Tubo-ovarian abscesses with inflammation extending along the right paracolic
gutter up to the subhepatic region and presenting with right upper quadrant pain.

11. Bilateral tubo-ovarian abscesses.

19. Cystadenoma and cystadenofibroma.

20. Serous cystadenoma

26. High signal intensity on T2-weighted imaging but which remains of high signal intensity
on T1 fat-saturated images without enhancement, consistent with hemorrhagic cyst.

27. Bilateral hemorrhagic cysts.

29. Polycystic ovary syndrome.

31. Endometrioma. Axial T2-weighted image (a) shows an ovarian cystic mass with intermediate
signal intensity. Axial T1 fat suppression weighted image (b) confirms the hemorrhagic nature of
the cyst (endometrioma). Note a mural nodule located posterior on the left side of the wall (b,
arrow). 3D fat-saturated T1-weighted Spoiled Gradient Echo images before (c) and after
intravenous contrast injection with subtraction of precontrast and postcontrast sequences (d)
demonstrate the lack of enhancement of the mural nodule due to blood clot.

33. Dermoid cyst.

35. Two cases of mature (cystic) ovarian teratoma.

36. Ovarian dermoid.

37. Mucinous cystadenoma.

38. Ovarian serous adenofibroma.

39. Ovarian fibroma.

40. CARCINOMA OF THE OVARY:
Pathology. I. Histologic classification.
* from all cells of the ovary (epithelial, germinal, and stromal);
* 85% = of epithelial origin (from coelomic epithelium or
mesothelium from embryonal gonadal ridge);
* 15% = from a variety of cell types (the tissue of origin is often
identified, but some tumors have more than one cell type)

41. 1. Epithelial cell = 85%:
Serous; Mucinous; Endometrioid;
Mesonefroid (clear cell);
Brenner; Undifferentiated; Carcinosarcoma;
II. Stromal cell < 10%: Granulosa; Thecoma; Arrhenoblastoma;
Sertoli; gynandroblastoma; Lipoid
III. Germ cell < 5%: Teratoma (NOS, dermoid cyst, struma ovarii);
Teratocarcinoma;
Dysgerminoma;
Embryonal carcinoma;
Endodermal sinus;
Chorioncarcinoma;
Gonadoblastoma;
Mixed tumors;
IV. Mesenchymal cell = 2%
CARCINOMA OF THE OVARY
Histologic classification

50. Serous ovarian
cystadenocarcinoma.

51. Mucinous ovarian cystadenocarcinoma

55. Brenner tumour with mucinous portion. Collision tumour. Axial T2- (a) and T1-weighted (b)
images demonstrate an adnexal multilocular cystic mass with thin septations and a solid
posterior hypointense portion (a, arrow). The cystic portion presents multiple loculi with
different contents characterized by different signal intensity. The septations and the solid
portion present an homogeneous and delayed enhancement on 3D fat-saturated T1-
weighted Spoiled Gradient Echo images (c, arrow). The interface between the solid and the
cystic mass is regular.

56. Malignant ovarian mixed germ cell tumour

57. Ovarian Carcinoma.

58. Two cases of Ovarian serous cystadenocarcinoma.

59. Juvenile Granulosa Cell Tumor of the Ovary.

60. Squamous cell carcinoma arising in mature cystic teratoma (dermoid cyst).

61. Squamous cell carcinoma arising from a mature cystic teratoma of the right ovary.

62. Endometrioid ovarian carcinoma

63. Endometrioid ovarian carcinoma

64. Two cases of ovarian carcinosarcoma

65. Grade 2 immature teratoma of the right ovary

66. Grade 2 immature teratoma of the right ovary.

67. Grade 3 immature teratoma of the right ovary

68. Dysgerminoma of the left ovary.

69. Bilateral dysgerminoma in a 18-year-old.

70. Yolk sac tumour of the left ovary.

71. Embryonal carcinoma.

73. Papillary carcinoma of the ovary.

74. Malignant mixed germ cell tumour comprising of both
embryonal carcinoma and yolk sac tumour of the right ovary.

75. Malignant mixed germ cell tumour comprising of both embryonal
carcinoma and yolk sac tumour of the right ovary

76. Endodermal Sinus Tumor – staging PET

77. Cystic metastases to the ovaries

80. Thank You.