# O-RADS MRI — Ovarian-Adnexal Reporting and Data System, MRI

> MRI risk stratification of adnexal lesions.

**Situação:** vigente · **Órgão:** Ovário e anexos · **Órgão emissor:** American College of Radiology · **Versão:** 2021 · **Ano:** 2021

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: MRI
- Fonte primária: Thomassin-Naggara I, Belghitti M, Milon A, et al.. O-RADS MRI risk stratification system for adnexal lesions (2021) — https://pmc.ncbi.nlm.nih.gov/articles/PMC9254700/
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 1 | O-RADS MRI 1 | Normal ovaries / no adnexal lesion: non-ovarian lesion, or a normal physiologic structure such as a follicle (simple cyst <=3 cm), corpus luteum, or hemorrhagic cyst. | No follow-up or additional imaging needed for the ovaries. | No assigned malignancy risk (normal ovaries). | PMC9254700, Table 1 'O-RADS MRI scoring system' (Materials and Methods): Score 1 'Normal ovaries' = 'Non-ovarian lesion. Follicle (simple cyst <= 3 cm), corpus luteum, or hemorrhagic cyst'; PPV listed as not applicable. Management per ACR O-RADS MRI committee guideline (Sadowski/Thomassin-Naggara, Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672). | ✓ |
| 2 | O-RADS MRI 2, almost certainly benign | Almost certainly benign lesion: unilocular cyst with simple or endometriotic fluid content, with a smooth enhancing wall and no enhancing solid tissue. | No further imaging generally required; managed by the gynecologist as clinically indicated. | PPV for malignancy < 0.5%. | PMC9254700, Table 1 'O-RADS MRI scoring system': Score 2 (Almost certainly benign) = 'Unilocular cyst with simple or endometrial fluid content (smooth enhancing wall and no enhancing solid tissue)', PPV < 0.5%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672). | ✓ |
| 3 | O-RADS MRI 3, low risk | Low-risk lesion: unilocular cyst with proteinaceous, hemorrhagic, or mucinous fluid content, with a smooth enhancing wall and no enhancing solid tissue. | Consider short-interval follow-up (e.g. ultrasound within ~6 months) if not excised; specialist MRI or gynecologist referral as needed for solid components. | PPV for malignancy approximately 5%. | PMC9254700, Table 1 'O-RADS MRI scoring system': Score 3 (Low risk) = 'Unilocular cyst with proteinaceous, hemorrhagic or mucinous fluid content (smooth enhancing wall and no enhancing solid tissue)', PPV ~ 5%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672). | ✓ |
| 4 | O-RADS MRI 4, intermediate risk | Intermediate-risk lesion: a lesion containing enhancing solid tissue showing an intermediate-risk (type 2) time-intensity curve on dynamic contrast-enhanced (DCE) MRI. | Gynecologic oncology consultation or referral; evaluation per a gynecologic-oncology protocol given the substantial malignancy risk. | PPV for malignancy approximately 50%. | PMC9254700, Table 1 'O-RADS MRI scoring system': Score 4 (Intermediate risk) = 'Lesion with solid tissue: intermediate-risk (type 2) time-intensity curve on DCE MRI', PPV ~ 50%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672). | ✓ |
| 5 | O-RADS MRI 5, high risk | High-risk lesion: a lesion containing enhancing solid tissue showing a high-risk time-intensity curve on dynamic contrast-enhanced (DCE) MRI (or peritoneal/serosal/mesenteric implants). | Direct gynecologic oncology referral; management per gynecologic-oncology protocol. | PPV for malignancy approximately 90%. | PMC9254700, Table 1 'O-RADS MRI scoring system': Score 5 (High risk) = 'Lesion with solid tissue: high risk time-intensity curve on DCE MRI', PPV ~ 90%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672). | ✓ |

### Citações por categoria
- **1**: Thomassin-Naggara I, Belghitti M, Milon A, et al.. O-RADS MRI risk stratification system for adnexal lesions (2021) — https://pmc.ncbi.nlm.nih.gov/articles/PMC9254700/ · PMC9254700, Table 1 'O-RADS MRI scoring system' (Materials and Methods): Score 1 'Normal ovaries' = 'Non-ovarian lesion. Follicle (simple cyst <= 3 cm), corpus luteum, or hemorrhagic cyst'; PPV listed as not applicable. Management per ACR O-RADS MRI committee guideline (Sadowski/Thomassin-Naggara, Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672).
- **2**: Thomassin-Naggara I, Belghitti M, Milon A, et al.. O-RADS MRI risk stratification system for adnexal lesions (2021) — https://pmc.ncbi.nlm.nih.gov/articles/PMC9254700/ · PMC9254700, Table 1 'O-RADS MRI scoring system': Score 2 (Almost certainly benign) = 'Unilocular cyst with simple or endometrial fluid content (smooth enhancing wall and no enhancing solid tissue)', PPV < 0.5%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672).
- **3**: Thomassin-Naggara I, Belghitti M, Milon A, et al.. O-RADS MRI risk stratification system for adnexal lesions (2021) — https://pmc.ncbi.nlm.nih.gov/articles/PMC9254700/ · PMC9254700, Table 1 'O-RADS MRI scoring system': Score 3 (Low risk) = 'Unilocular cyst with proteinaceous, hemorrhagic or mucinous fluid content (smooth enhancing wall and no enhancing solid tissue)', PPV ~ 5%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672).
- **4**: Thomassin-Naggara I, Belghitti M, Milon A, et al.. O-RADS MRI risk stratification system for adnexal lesions (2021) — https://pmc.ncbi.nlm.nih.gov/articles/PMC9254700/ · PMC9254700, Table 1 'O-RADS MRI scoring system': Score 4 (Intermediate risk) = 'Lesion with solid tissue: intermediate-risk (type 2) time-intensity curve on DCE MRI', PPV ~ 50%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672).
- **5**: Thomassin-Naggara I, Belghitti M, Milon A, et al.. O-RADS MRI risk stratification system for adnexal lesions (2021) — https://pmc.ncbi.nlm.nih.gov/articles/PMC9254700/ · PMC9254700, Table 1 'O-RADS MRI scoring system': Score 5 (High risk) = 'Lesion with solid tissue: high risk time-intensity curve on DCE MRI', PPV ~ 90%. Management per ACR O-RADS MRI committee guideline (Radiology 2022, doi 10.1148/radiol.204371; PMID 35040672).

## Referências cruzadas
- _encaminha para_ → [O-RADS US — Ovarian-Adnexal Reporting and Data System, ultrasound](https://radcommons.laudos.ai/systems/o-rads-us-2020.md) — O-RADS MRI is used to further characterize indeterminate lesions seen on O-RADS US.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2021-01-01 | published | O-RADS MRI risk stratification system published. | confirmed |


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