Management of Incidental Findings in the Adnexa

incidental-adnexal

Which option best describes the finding? *

Simple appearing cyst

Hemorrhagic cyst

Simple Hydrosalpinx, Ovarian fibroma, Para-ovarian cyst or peritoneal inclusion cyst

Dermoid or endometrioma

Suspected malignancy

Diagnosis uncertain

* Exclusions:
(1) normal findings, including crenulated enhancing wall of corpus luteum, asymmetric ovary without mass, with normal shape
(2) calcifications without associated noncalcified mass
(3) previous characterization with ultrasound (US) or MRI
documented stability in size and appearance for 2 years.

What is the maximum dimension of the cyst? (cm)

What is the imaging modality?

CT

MRI

How is the patient's menopausal status?

Pre-pmenopausal, or Status unknown in < 50 years old

Post-menopausal, or Status unknown in ≥ 50 years old

How is the patient's menopausal status?

Pre-pmenopausal, or Status unknown in < 50 years old

Post-menopausal, or Status unknown in ≥ 50 years old

Is the cyst fully characterized on this exam?

Limited assessment *

Fully characterized

* Cyst is consistent with a simple appearing cyst, but characterization is limited by low signal-to-noise ratio, artifact, lack of contrast assessment, or incomplete anatomic coverage

Is the cyst fully characterized on this exam?

Limited assessment *

Fully characterized

* Cyst is consistent with a simple appearing cyst, but characterization is limited by low signal-to-noise ratio, artifact, lack of contrast assessment, or incomplete anatomic coverage

Recommendation:

No further imaging

Recommendation:

No further imaging

Recommendation:

No further imaging

Recommendation:

No further imaging

Recommendation:

No further imaging

Recommendation:

Further characterization with ultrasound

Recommendation:

Ultrasound follow-up in 6-12 months

Recommendation:

Ultrasound follow-up in 6-12 months

Recommendation:

Ultrasound follow-up in 6-12 months

Recommendation:

Ultrasound follow-up in 6-12 months

Recommendation:

Further evaluation with ultrasound or MRI

Recommendation:

Further evaluation with ultrasound or MRI

Recommendation:

Further imaging per gynecology recommendations.

Recommendation:

Ultrasound follow-up in 2-3 months

Click here to visit the incidental findings page on ACR.

References:

Patel MD, Ascher SM, Horrow MM, et al. Management of Incidental Adnexal Findings on CT and MRI: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2020;17(2):248-254. doi:10.1016/j.jacr.2019.10.008

Management of Radiology Incidental Findings in the Adnexa

References:

Share your thoughts Cancel reply