Get a Group Membership for your Organization. Free Trial
Pricing
Free TrialLogin

Overview & Normal Ovarian Physiology

HIDE
PrevNext

0:01

Okay, so today we're going to talk about

0:03

a few things in terms of ovarian masses.

0:05

So firstly, we'll talk about the

0:07

anatomy and normal physiology,

0:09

that's important as radiologists.

0:12

And then the clinical significance of

0:13

ovarian lesions is also very important

0:17

when we're interpreting our cases,

0:19

because there is quite a spectrum of

0:21

appearances of ovarian lesions and ovaries.

0:25

In general, I like to think of them as

0:27

little factories producing eggs over time.

0:29

So there is a difference in appearance

0:32

of the ovary in the pre-menopausal and

0:35

the post-menopausal stage, depending

0:37

on the physiology of the patient.

0:40

So we can have a spectrum of

0:41

appearances from physiologic to non-neoplastic

0:44

to neoplastic lesions.

0:46

And as radiologists, it's challenging for us

0:48

to determine when to work up these lesions.

0:51

So then we'll talk a little bit about O.

0:52

Rads, which is a mechanism of characterizing

0:56

and triaging lesions for further workup.

0:59

We'll briefly go over imaging protocols,

1:01

and then we'll spend some time talking

1:03

about some common manifestations of

1:06

ovarian and pelvic disease, including

1:08

endometriosis and ovarian masses.

1:12

So let's begin by talking about

1:14

normal ovarian physiology.

1:17

Now, there are several categories of

1:19

adnexal lesions, ranging from a simple

1:23

appearing cyst to a characteristic

1:26

diagnosis to an uncertain diagnosis.

1:29

And as radiologists, it's up to us to be

1:31

able to kind of triage and differentiate

1:35

between those broad categories.

1:38

And one of the most challenging areas

1:41

that we need to feel comfortable with is

1:43

determining what actually needs workup.

1:46

So in my experience over time, I've noticed

1:49

that in general, radiologists, including

1:51

myself, often work up too many ovarian lesions.

1:55

So it's usually after several years of practice

1:58

and experience that you start to refine

2:01

your approach in terms of working up ovarian

2:05

lesions, you get a bit of a different threshold

2:08

as to what's normal and what's not normal.

2:10

In the beginning, you may want to work up

2:13

a lot of different appearances because your

2:15

exposure and experience may not be very broad.

2:17

And then slowly over time, we tend to kind of

2:20

raise our threshold for working up lesions.

2:23

And many of the different appearances

2:25

that we see and sometimes work up are

2:27

actually physiologic manifestations

2:29

of the normal ovarian cycle.

2:32

And it's important to keep in mind that even

2:35

though we tend to work up a lot of these cystic

2:37

lesions, over 99 percent of them in any age

2:41

group, when they're greater than 10 centimeters,

2:43

even at that size, they tend to be benign.

2:46

So, That for me was really striking when I

2:50

learned about that because it really gave me

2:52

a little bit more comfort in trying to raise

2:55

my threshold for what I was going to work up.

2:57

So if you keep that in mind, and even in the

2:59

postmenopausal age group, most of the cysts

3:02

you're going to see are actually benign.

3:04

So that's a little bit reassuring and makes

3:05

you feel a little bit better about making

3:08

your follow-up period of time a little bit

3:10

longer, or maybe not working up certain things

3:13

that really have no concerning features.

3:15

Thanks.

Report

Faculty

Zahra Kassam, MD, FRCPC

Associate Professor of Medical Imaging, Division Head of Body Imaging

Western University

Tags

Ultrasound

Ovaries

Non-infectious Inflammatory

Neoplastic

MRI

Gynecologic (GYN)

CT

Body

© 2024 MRI Online. All Rights Reserved.

Contact UsTerms of UsePrivacy Policy