Advertisements
| O-RADS MRI score | Risk category | Positive predictive value for malignancy | Remarks |
| 0 | Incomplete evaluation | – | – |
| 1 | Normal ovaries | – | No ovarian lesion |
| Simple cyst < or equal to 3 cm in premenopausal women | |||
| Hemorrhagic cyst < or equal to 3 cm in premenopausal women | |||
| Corpus luteum with or without hemorrhage < or equal to 3 cm in premenopausal women | |||
| 2 | Almost certainly benign | < 0.5% | Cyst: unilocular, any type of fluid content. No wall enhancement. No enhancing solid tissue |
| Cyst: unilocular, simple or endometriotic fluid content. Smooth enhancing wall. No enhancing solid tissue | |||
| Lesion with lipid content. No enhancing solid tissue | |||
| Lesion with dark T2 or DWI solid component. Homogeneously hypo intense in both T2 and DWI | |||
| Dilated fallopian tube – simple fluid content. Thin smooth walls with enhancement. No enhancing solid tissue | |||
| Para-ovarian cyst: any type of fluid. Thin, smooth wall enhancement. No solid enhancing tissue | |||
| 3 | Low risk | Around 5% | Cyst: unilocular – proteinaceous, hemorrhagic or mucinous fluid content. Smooth enhancing wall. No enhancing solid tissue |
| Cyst: multilocular, any type of fluid. No lipid content. Smooth septa and wall with enhancement. No enhancing solid tissue. | |||
| Lesion with solid tissue. Low risk curve on DCE MRI. | |||
| Dilated fallopian tube. Non simple fluid – thin walls. Simple fluid with thick walls. No enhancing solid tissue | |||
| 4 | Intermediate risk | Around 50% | Lesion with solid tissue. Intermediate risk curve on DCE MRI. Solid tissue enhancing less than myometrium |
| Lesion with lipid content. Large volume enhancing solid tissue | |||
| 5 | High risk | Around 90% | Lesion with solid tissue. High risk curve on DCE MRI. Tissue enhancing >myometrium at 30-40s |