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DOI: 10.1016/j.rxeng.2020.11.009
Available online 21 May 2021
Ovarian fibromatosis: “The black garland sign”
Fibromatosis ovárica: “signo de la guirnalda negra”
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M. Santos Urios
Corresponding author
msantosurios@gmail.com

Corresponding author.
, C. García Espasa, L. Concepción Aramendía
Servicio de Radiodiagnóstico, Hospital General Universitario de Alicante, Alicante, Spain
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Abstract

The main objective in the imaging differential diagnosis of an ovarian mass is to establish whether it is cystic or solid; solid lesions are less common. Ovarian fibromatosis is a benign disease of the ovary that is rarely included in the differential diagnosis of solid ovarian lesions. Characteristic features of masses that have a fibrous component are low signal in T1-weighted MRI sequences and especially in T2-weighted MRI sequences. The presence of peripheral fibrotic tissue around the residual ovarian tissue is specific to ovarian fibromatosis; on MRI, this results in marked hypointensity on T2-weighted images that has been dubbed the “black garland sign”. This sign, together with slight peripheral enhancement after the administration of contrast material and the preservation of the ovarian architecture, facilitates the diagnosis, making it possible to avoid unnecessary surgical interventions.

Keywords:
Neoplasms
Fibrous tissue
Magnetic resonance imaging
Ovarian diseases
Resumen

El primer objetivo del diagnóstico diferencial por imagen ante una masa ovárica es establecer su naturaleza quística o, menos frecuente, sólida. La fibromatosis ovárica es una patología benigna del ovario rara, incluida en el diagnóstico diferencial ante el hallazgo de lesiones ováricas sólidas. Características propias de las masas que presentan componente fibrótico son su baja señal en secuencias de resonancia magnética potenciadas en T1 y especialmente en T2. La presencia de tejido fibrótico periférico alrededor del tejido ovárico residual es una característica específica en la fibromatosis ovárica y que tiene como traducción en la RM una marcada hipointensidad en T2 conocida como “signo de la guirnalda negra”. Este signo, junto con una débil captación poscontraste periférica, así como la preservación de la arquitectura ovárica, nos facilita el diagnóstico y puede evitar cirugías innecesarias.

Palabras clave:
Neoplasias
Tejido fibroso
Resonancia magnética
Enfermedades del ovario

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