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The MRI features of histologically proven ovarian cystadenofibromas—an assessment of the morphological and enhancement patterns

  • Magnetic Resonance
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To assess the morphological and enhancement features of histologically proven cystadenofibromas (CAFs) on magnetic resonance imaging (MRI).


Forty-seven histologically proven CAFs (42 benign, five borderline) were retrospectively reviewed. One benign CAF had a synchronous adenocarcinoma in the same ovary. The morphological, signal and enhancement characteristics on MRI were recorded.


The mean long axis diameter of the CAFs was 80 mm. The contralateral ovary was abnormal in 45 % of cases. A solid component was seen in 85 %, which returned low T2-weighted signal in 75 % of CAFs. Septa were seen in 74 % and one CAF was purely cystic. The majority of solid components and septa demonstrated enhancement that was less than the myometrium. Wash-in rates (WIR) of the solid tissue were available for measurement in nine patients with an average WIR of 3.2 l/s.


This is the largest series describing MRI appearances of histologically proven CAFs. They are typically complex adnexal lesions containing septa, cystic components and solid tissue. The majority of solid components demonstrate low T2 signal and minimal enhancement. Almost half of the cases have an abnormal contralateral ovary.

Key Points

Cystadenofibromas are complex adnexal lesions containing septa, cystic, and solid components.

Some MRI features of cystadenofibromas overlap with those of malignant ovarian lesions.

Almost 50 % of patients with a cystadenofibroma have an abnormal contralateral ovary.

Most contralateral lesions are benign, but we found four borderline tumours.

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Correspondence to Yen Zhi Tang.

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Tang, Y.Z., Liyanage, S., Narayanan, P. et al. The MRI features of histologically proven ovarian cystadenofibromas—an assessment of the morphological and enhancement patterns. Eur Radiol 23, 48–56 (2013).

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