The presence of macroscopic fat, with or without the presence of calcification and/or Rokitansky nodule, is diagnostic of a dermoid if seen on CT. CT Pelvis Without and With IV Contrast CT pelvis without and with IV contrast is typically not useful for the initial workup and characterization of adnexal masses due to suboptimal delineation of soft tissue in the adnexal region. The presence of macroscopic fat, with or without the presence of calcification and/or Rokitansky nodule, is diagnostic of a dermoid if seen on CT. CT Pelvis Without IV Contrast CT pelvis without IV contrast is typically not useful for the initial workup and characterization of adnexal masses due to suboptimal delineation of soft tissue in the adnexal region. The presence of macroscopic fat, with or without the presence of calcification and/or Rokitansky nodule, is diagnostic of a dermoid if seen on CT. FDG-PET/CT Skull Base to Mid-Thigh Fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT is not useful for the initial workup and characterization of adnexal masses due to suboptimal delineation of soft tissue in the adnexal region. MRI Pelvis Without and With IV Contrast MRI can accurately diagnose the presence of adnexal lesions and identify enhancing soft tissue as well as other distinguishing characteristics such as the type of fluid content, presence of fat, or presence of septations in a cystic lesion. It performs superior to US; however, it is not the first-line modality for initial evaluation [16,17]. If a patient with a suspected adnexal lesion is unable to be evaluated via US (due to large size of lesion >10 cm, poor acoustic window from adjacent viscera or body habitus, or unclear organ of origin), MRI would be the best alternative imaging modality for evaluation. MRI Pelvis Without IV Contrast If MRI is being used for evaluation of a suspected adnexal lesion, IV contrast is recommended to evaluate for any internal enhancing component.
Clinically Suspected Adnexal Mass No Acute Symptoms. The presence of macroscopic fat, with or without the presence of calcification and/or Rokitansky nodule, is diagnostic of a dermoid if seen on CT. CT Pelvis Without and With IV Contrast CT pelvis without and with IV contrast is typically not useful for the initial workup and characterization of adnexal masses due to suboptimal delineation of soft tissue in the adnexal region. The presence of macroscopic fat, with or without the presence of calcification and/or Rokitansky nodule, is diagnostic of a dermoid if seen on CT. CT Pelvis Without IV Contrast CT pelvis without IV contrast is typically not useful for the initial workup and characterization of adnexal masses due to suboptimal delineation of soft tissue in the adnexal region. The presence of macroscopic fat, with or without the presence of calcification and/or Rokitansky nodule, is diagnostic of a dermoid if seen on CT. FDG-PET/CT Skull Base to Mid-Thigh Fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT is not useful for the initial workup and characterization of adnexal masses due to suboptimal delineation of soft tissue in the adnexal region. MRI Pelvis Without and With IV Contrast MRI can accurately diagnose the presence of adnexal lesions and identify enhancing soft tissue as well as other distinguishing characteristics such as the type of fluid content, presence of fat, or presence of septations in a cystic lesion. It performs superior to US; however, it is not the first-line modality for initial evaluation [16,17]. If a patient with a suspected adnexal lesion is unable to be evaluated via US (due to large size of lesion >10 cm, poor acoustic window from adjacent viscera or body habitus, or unclear organ of origin), MRI would be the best alternative imaging modality for evaluation. MRI Pelvis Without IV Contrast If MRI is being used for evaluation of a suspected adnexal lesion, IV contrast is recommended to evaluate for any internal enhancing component.