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Okay, so today we're going to talk about

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a few things in terms of ovarian masses.

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So firstly, we'll talk about the

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anatomy and normal physiology,

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that's important as radiologists.

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And then the clinical significance of

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ovarian lesions is also very important

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when we're interpreting our cases,

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because there is quite a spectrum of

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appearances of ovarian lesions and ovaries.

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In general, I like to think of them as

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little factories producing eggs over time.

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So there is a difference in appearance

0:32

of the ovary in the pre-menopausal and

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the post-menopausal stage, depending

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on the physiology of the patient.

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So we can have a spectrum of

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appearances from physiologic to non-neoplastic

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to neoplastic lesions.

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And as radiologists, it's challenging for us

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to determine when to work up these lesions.

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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.

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We'll briefly go over imaging protocols,

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and then we'll spend some time talking

1:03

about some common manifestations of

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ovarian and pelvic disease, including

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endometriosis and ovarian masses.

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So let's begin by talking about

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normal ovarian physiology.

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Now, there are several categories of

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adnexal lesions, ranging from a simple

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appearing cyst to a characteristic

1:26

diagnosis to an uncertain diagnosis.

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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.

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And one of the most challenging areas

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that we need to feel comfortable with is

1:43

determining what actually needs workup.

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So in my experience over time, I've noticed

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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.

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And then slowly over time, we tend to kind of

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raise our threshold for working up lesions.

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And many of the different appearances

2:25

that we see and sometimes work up are

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actually physiologic manifestations

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of the normal ovarian cycle.

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And it's important to keep in mind that even

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though we tend to work up a lot of these cystic

2:37

lesions, over 99 percent of them in any age

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group, when they're greater than 10 centimeters,

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even at that size, they tend to be benign.

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So, That for me was really striking when I

2:50

learned about that because it really gave me

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a little bit more comfort in trying to raise

2:55

my threshold for what I was going to work up.

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

2:59

postmenopausal age group, most of the cysts

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you're going to see are actually benign.

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So that's a little bit reassuring and makes

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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.