الفهرس 
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Abstract
Ovarian carcinoma is an insidious disease, and patients often present with an advanced (extra pelvic) stage of disease. Despite clinical advance and improved surgical techniques, it remains the deadliest form of gynecologic malignancy.
The primary goal of imaging in the evaluation of an adnexal mass is to differentiate malignant and benign diagnosis in order to direct patients to the appropriate treatment algorithm.
Magnetic resonance (MR) imaging has been proved useful for characterizing benign and malignant ovarian tumors; moreover, it enables a specific diagnosis to be made for certain pathologic types. For example, MR imaging is well known to provide accurate information about hemorrhage, fat, and collagen.
Gadolinium- enhanced MR imaging serves as a problem-solving modality in cases of indeterminate adnexal masses. A combination of T1 –weighted images and T1- weighted images with fat saturation helps to differentiate most common benign adnexal masses from malignant ones.
Magnetic resonance spectroscopy is a non invasive means of obtaining metabolic information by recording signals from metabolites present in tissues, while the water signal is suppressed. Magnetic Resonance Spectroscopy (MRS) plays an important role in the detection of ovarian tumors by differentiating between them whether being benign or malignant.
Functional imaging is becoming increasingly important in the evaluation of cancer patients because of the limitations of morphologic imaging. Evaluation of the signal intensity on the DW1 sequence should always be correlated to the imaging features on conventional sequences and the possibility of T2 shine through or hemorrhage as a cause of hyperintensity on b=1000 diffusion images should always be considered.
U/S has long been the primary imaging modality used to evaluate patients with known or suspected ovarian abnormality. Up to most recent studies, sonography has remained the preferred method in the initial evaluation of ovarian neoplasms due to its many advantages over other modalities.
MRI is now the method of choice when U/S is indeterminate in the evaluation of the ovary and adnexal masses. MRI can also be used to diagnose more uncommon conditions.
In conclusion, improvements in MRI diagnostic and staging accuracies is achieved when supplemented with DCE-MRI, MRS and DW1