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Management of Incidental Adnexal Lesions
Douglas Rogers, MD
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KEY FACTS

  • Terminology

    • Clinical Implications

      TERMINOLOGY

      • Background

        • Definitions and algorithms are generated from 2020 American College of Radiology (ACR) White Paper for management of incidental adnexal findings on CT or MR
          • Contains updates to 2013 version
        • Algorithms for incidental cysts detected on ultrasound originate from 2019 Society of Radiologists in Ultrasound (SRU) consensus update for follow-up and reporting for simple adnexal cysts
      • Definitions

        • Simple cyst: Sonographically characterized
          • Round/oval lesion
          • Smooth, thin walls
          • No solid component or septation
          • No internal blood flow
        • Simple-appearing cyst: CT/MR terminology
          • Round/oval lesion
          • Fluid attenuation (-10 to 20 HU)
          • MR fluid signal (T2 hyperintense, T1 hypointense)
          • Smooth, imperceptible or thin wall
          • No enhancement

      CLINICAL IMPLICATIONS

      • Background

        • Reporting

          • Algorithm

            Selected References

            1. Patel MD et al: Management of incidental adnexal findings on CT and MRI: a White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 17(2):248-54, 2020
            2. Levine D et al: Simple adnexal cysts: SRU Consensus Conference update on follow-up and reporting. Radiology. 293(2):359-71, 2019
            3. Patel MD et al: Managing incidental findings on abdominal and pelvic CT and MRI, part 1: White Paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol. 10(9):675-81, 2013
            Related Anatomy
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            References
            Tables

            Tables

            KEY FACTS

            • Terminology

              • Clinical Implications

                TERMINOLOGY

                • Background

                  • Definitions and algorithms are generated from 2020 American College of Radiology (ACR) White Paper for management of incidental adnexal findings on CT or MR
                    • Contains updates to 2013 version
                  • Algorithms for incidental cysts detected on ultrasound originate from 2019 Society of Radiologists in Ultrasound (SRU) consensus update for follow-up and reporting for simple adnexal cysts
                • Definitions

                  • Simple cyst: Sonographically characterized
                    • Round/oval lesion
                    • Smooth, thin walls
                    • No solid component or septation
                    • No internal blood flow
                  • Simple-appearing cyst: CT/MR terminology
                    • Round/oval lesion
                    • Fluid attenuation (-10 to 20 HU)
                    • MR fluid signal (T2 hyperintense, T1 hypointense)
                    • Smooth, imperceptible or thin wall
                    • No enhancement

                CLINICAL IMPLICATIONS

                • Background

                  • Reporting

                    • Algorithm

                      Selected References

                      1. Patel MD et al: Management of incidental adnexal findings on CT and MRI: a White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 17(2):248-54, 2020
                      2. Levine D et al: Simple adnexal cysts: SRU Consensus Conference update on follow-up and reporting. Radiology. 293(2):359-71, 2019
                      3. Patel MD et al: Managing incidental findings on abdominal and pelvic CT and MRI, part 1: White Paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol. 10(9):675-81, 2013