Pearls and Potential Pitfalls for Correct Diagnosis of Ovarian Cystadenofibroma in MRI: A Pictorial Essay

Korean J Radiol. 2021 Nov;22(11):1809-1821. doi: 10.3348/kjr.2020.1312. Epub 2021 Sep 24.

Abstract

Ovarian cystadenofibroma is a benign ovarian tumor that is characterized by a consistent percentage of masses, which remain indeterminate in ultrasonography and require magnetic resonance (MR) investigation; they may mimic borderline or malignant lesions. Three main morphologic patterns, resembling different ovarian neoplasms, can be identified in cystadenofibromas: multilocular solid lesions, unilocular cystic lesions with parietal thickening, and purely cystic masses. However, a cystoadenofibroma has typical features, such as T2-weighted hypointensity associated with no restrictions in diffusion-weighted imaging (the so-called "dark-dark appearance") and progressive post-contrast enhancement (type I perfusion curve). The purpose of this study was to review the features of ovarian cystadenofibromas in MR imaging and to suggest pearls and pitfalls regarding their correct diagnosis.

Keywords: Cystadenofibroma; Epithelial-stromal tumours; MR imaging; Ovarian neoplasm.

Publication types

  • Review

MeSH terms

  • Cystadenofibroma* / diagnostic imaging
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Ovarian Neoplasms* / diagnostic imaging
  • Ultrasonography