Imaging of adnexal masses in pregnancy.

OBJECTIVE: To illustrate the imaging appearances of a variety of adnexal masses in pregnancy.

METHODS: Cases of adnexal masses in pregnancy were chosen to illustrate the appearance on ultrasonography and magnetic resonance imaging.

RESULTS: Adnexal masses in pregnancy have a wide spectrum of imaging characteristics and clinical manifestations. Sonography is important in diagnosing, monitoring, and determining the malignant potential of these masses. Common adnexal lesions seen in pregnancy include simple cysts, hemorrhagic cysts, leiomyomas, and hyperstimulated ovaries in patients who have undergone assisted fertility. Uncommon adnexal lesions specific to pregnancy include hyperreactio luteinalis, theca lutein cysts with moles, and luteomas. Adnexal masses associated with pain include ovarian torsion and heterotopic pregnancy. Adnexal lesions that are found incidentally include teratomas, endometriomas, hydrosalpinx, cystadenomas, and cystadenocarcinomas. When the diagnosis of the adnexal mass cannot be made on the basis of sonographic appearance alone, magnetic resonance imaging may help.

CONCLUSIONS: Familiarity with the clinicopathologic and sonographic features of common and uncommon adnexal masses in pregnancy is important for diagnosis and treatment.