🩻 O-RADS MRI Risk Score (Adnexal Lesions)
UseMRI characterization of sonographically indeterminate adnexal lesions; pairs with the O-RADS US tool.
SourceThomassin-Naggara I, et al. JAMA Netw Open 2020;3:e1919896
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Peritoneal disease = 5.
When to use
MRI characterization of sonographically indeterminate adnexal lesions; pairs with the O-RADS US tool.
How it works
Peritoneal disease → 5; solid tissue: dark T2 + dark DWI → 2, else DCE low/intermediate/high curve → 3/4/5, non-DCE ≤ / > myometrium → 4/5; unilocular no wall enhancement → 2; simple/endometriotic with smooth enhancing wall → 2, other fluid → 3; multilocular without solid tissue → 3; lipid → 2 (4 with large solid); dilated tube simple & thin → 2, non-simple or thick wall → 3; premenopausal follicle / corpus luteum / hemorrhagic cyst ≤ 3 cm → 1; multilocular-appearing endometriomas → 2.
Key points
- Peritoneal disease = 5.
- Dark T2 + dark DWI solid = 2.
- DCE curve sets 3/4/5.
- Multilocular without solid tissue = 3.
References
- Thomassin-Naggara I, et al. JAMA Netw Open 2020;3:e1919896
- Sadowski EA, et al. Radiology 2022;303:35-47
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Side | Left adnexa |
|---|---|
| Maximum diameter | 4.5 cm |
| MRI lesion type | Lesion with lipid content (T1 bright, suppresses with fat sat) |
| Enhancing solid tissue in lipid lesion | None, or minimal Rokitansky nodule enhancement |
| Peritoneal / mesenteric / omental nodularity or irregular thickening (± ascites) | No |
→O-RADS MRI2
- Basis：Lipid lesion without enhancing solid tissue (minimal Rokitansky enhancement does not upgrade)
- Risk of malignancy：Almost certainly benign (PPV < 0.5%)
- Management cue：Usually no imaging follow-up; gynecology as needed.
| Side | Right adnexa |
|---|---|
| Maximum diameter | 4.5 cm |
| MRI lesion type | No lesion / physiologic (premenopausal follicle, corpus luteum, hemorrhagic cyst ≤ 3 cm) |
| Peritoneal / mesenteric / omental nodularity or irregular thickening (± ascites) | No |
→O-RADS MRI1
- Basis：No lesion, or premenopausal follicle / corpus luteum / hemorrhagic cyst ≤ 3 cm
- Risk of malignancy：Normal ovaries
- Management cue：No further imaging.
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using O-RADS MRI Risk Score (Adnexal Lesions)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does O-RADS MRI Risk Score (Adnexal Lesions) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is O-RADS MRI Risk Score (Adnexal Lesions) calculated in practice? Can you show a worked example?
- Inputs: Side Left adnexa, Maximum diameter 4.5 cm, MRI lesion type Lesion with lipid content (T1 bright, suppresses with fat sat), Enhancing solid tissue in lipid lesion None, or minimal Rokitansky nodule enhancement, Peritoneal / mesenteric / omental nodularity or irregular thickening (± ascites) No → Result: O-RADS MRI 2（Basis: Lipid lesion without enhancing solid tissue (minimal Rokitansky enhancement does not upgrade), Risk of malignancy: Almost certainly benign (PPV < 0.5%), Management cue: Usually no imaging follow-up; gynecology as needed.） Inputs: Side Right adnexa, Maximum diameter 4.5 cm, MRI lesion type No lesion / physiologic (premenopausal follicle, corpus luteum, hemorrhagic cyst ≤ 3 cm), Peritoneal / mesenteric / omental nodularity or irregular thickening (± ascites) No → Result: O-RADS MRI 1（Basis: No lesion, or premenopausal follicle / corpus luteum / hemorrhagic cyst ≤ 3 cm, Risk of malignancy: Normal ovaries, Management cue: No further imaging.）