Search

Serous borderline ovarian tumours (SBOTs) are an intermediate group of neoplasms, which have features between benign and malignant ovarian tumours and for which, fertility-sparing surgery can be offered. MRI in imaging of SBOTs is, therefore, crucial in raising the possibility of the diagnosis, in order to present the patient with the most appropriate treatment options. There are characteristic MRI features that SBOTs demonstrate. In addition, recent advanced techniques, and further classification into subtypes within the borderline group have been developed. The aim of this article is to review the MRI features of SBOT and provide the reporter with an awareness of the imaging tips and tricks in the differential diagnosis of SBOT.

Funder: Horizon 2020; doi: http://dx.doi.org/10.13039/501100007601, Funder: Cancer Research UK, Funder: Mark Foundation For Cancer Research; doi: http://dx.doi.org/10.13039/100014599, Purpose: To develop a precision tissue sampling technique that uses computed tomography (CT)–based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC). Methods: Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy. Results: We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7–30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76–0.79) while it was lower for the smaller omental metastases (DSC: 0.37–0.53). Conclusion: We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC. Key Points: • We developed a prevision tissue sampling technique that co-registers CT-based radiomics–based tumour habitats with US images. • The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76–0.79) while it was lower for the smaller omental metastases (DSC: 0.37–0.53).

Objectives To investigate the association between CT imaging traits and texture metrics with proteomic data in patients with high-grade serous ovarian cancer (HGSOC). Methods This retrospective, hypothesis-generating study included 20 patients with HGSOC prior to primary cytoreductive surgery. Two readers independently assessed the contrast-enhanced computed tomography (CT) images and extracted 33 imaging traits, with a third reader adjudicating in the event of a disagreement. In addition, all sites of suspected HGSOC were manually segmented texture features which were computed from each tumor site. Three texture features that represented intra- and inter-site tumor heterogeneity were used for analysis. An integrated analysis of transcriptomic and proteomic data identified proteins with conserved expression between primary tumor sites and metastasis. Correlations between protein abundance and various CT imaging traits and texture features were assessed using the Kendall tau rank correlation coefficient and the Mann-Whitney U test, whereas the area under the receiver operating characteristic curve (AUC) was reported as a metric of the strength and the direction of the association. P values Results Four proteins were associated with CT-based imaging traits, with the strongest correlation observed between the CRIP2 protein and disease in the mesentery (p p = 0.047, τ = 0.326). Conclusion This study provides the first insights into the potential associations between standard-of-care CT imaging traits and texture measures of intra- and inter-site heterogeneity, and the abundance of several proteins. Key Points • CT-based texture features of intra- and inter-site tumor heterogeneity correlate with the abundance of several proteins in patients with HGSOC. • CT imaging traits correlate with protein abundance in patients with HGSOC.

Background Simulation-based nursing training helps students develop skills, such as critical thinking, decision making, and the ability to manage cases. Method A two-group, nonrandomized, and quasi-experimental study examined the effect of using classical and simulation-based pediatric nursing training on students' perception of self-efficacy and anxiety levels as measured by the State–Trait Anxiety Scale. Cognitive learning and social learning theories guided our study. Participants were third-year undergraduate nursing students taking a pediatric nursing course from the same instructor during two different academic years in Turkey. The control group included 115 students selected from the spring term of the 2013 to 2014 education year, and the experimental group included 112 students selected from the spring term of the 2014 to 2015 education year. Results The simulation-based nursing training group's perception of self-efficacy was significantly higher in pediatric assessment, taking anthropometric measurements and vital signs, some medication administration, and care activities ( p p Conclusion Simulation-based nursing training enhances pediatric nursing students' perception of self-efficacy about their practice skills while reducing their anxiety level.

Objective: To assess the value of non-contrast MRI features for characterisation of uterine leiomyosarcoma (LMS) and differentiation from atypical benign leiomyomas Methods: This study included 57 atypical leiomyomas and 16 LMS which were referred pre-operatively for management review to the specialist gynaeoncology multidisciplinary team meeting. Non-contrast MRIs were retrospectively reviewed by five independent readers (three senior, two junior) and a 5-level Likert score (1-low/5-high) was assigned to each mass for likelihood of LMS. Evaluation of qualitative and quantitative MRI features was done using uni- and multivariable regression analysis. Inter-reader reliability for the assessment of MRI features was calculated by using Cohen’s κ values. Results: In the univariate analysis, interruption of the endometrial interface and irregular tumour shape had the highest odds ratios (ORs) (64.00, p < 0.001 and 12.00, p = 0.002, respectively) for prediction of LMS. Likert score of the mass was significant in prediction (OR, 3.14; p < 0.001) with excellent reliability between readers (ICC 0.86; 95% CI, 0.76–0.92). The post-menopausal status, interruption of endometrial interface and thickened endometrial stripe were the most predictive independent variables in multivariable estimation of the risk of leiomyosarcoma with an accuracy of 0.88 (95%CI, 0.78–0.94). Conclusion: At any level of expertise as a radiologist reader, the loss of the normal endometrial stripe (either thickened or not seen) in a post-menopausal patient with a myometrial mass was highly likely to be LMS. Advances in knowledge: This study demonstrates the potential utility of non-contrast MRI features in characterisation of LMS over atypical leiomyomas, and therefore influence on optimal management of these cases.

Although rare, uterine sarcoma is a diagnosis that no one wants to miss. Often benign leiomyomas (fibroids) and uterine sarcomas can be differentiated due to the typical low T2 signal intensity contents and well-defined appearances of benign leiomyomas compared to the suspicious appearances of sarcomas presenting as large uterine masses with irregular outlines and intermediate T2 signal intensity together with possible features of secondary spread. The problem is when these benign lesions are atypical causing suspicious imaging features. This article provides a review of the current literature on imaging features of atypical fibroids and uterine sarcomas with an aide-memoire BET1T2ER Check! to help identify key features more suggestive of a uterine sarcoma.

Objective Knowing the origin of the inferior phrenic artery (IPA) is important prior to surgical interventions and interventional radiological procedures related to IPA. We aimed to identify variations in the origin of IPA and to investigate the relationship between the origin of IPA and celiac axis variations using computed tomography angiography (CTA). Materials and methods The CTA images of 1000 patients (737 male and 263 female, the mean age 60, range 18-94 years) were reviewed in an analysis of IPA and celiac axis variations. The origin of IPA was divided into two groups, those originating as a common trunk and those originating independently without a truncus. The relationship between the origin of IPA and celiac axis variation was analyzed using Pearson's chi-square test. Results Both IPAs originated from a common trunk in 295 (29.5%) patients. From which the majority of the common trunk originated from the aorta. Contrastingly, the inferior phrenic arteries originated from different origins in 705 (70.5%) patients. The majority of the right inferior phrenic artery (RIPA) and the left inferior phrenic artery (LIPA) originated independently from the celiac axis. Variation in the celiac axis were detected in 110 (11%) patients. The origin of IPA was found to be significantly different in the presence of celiac axis variation. Conclusion The majority of IPA originated from the aorta in patients with a common IPA trunk, while the majority of RIPA and LIPA originating from the celiac axis in patients without a common IPA trunk. Thus, the origin of IPA may widely differ in the presence of celiac axis variation.

The duplication of the inferior vena cava (IVC) is a rare congenital anomaly, which also has some variations regarding the complex embryological development of the IVC. In the typical form, infrarenal IVC segments are duplicated and the left IVC joins the left renal vein, which crosses anterior to the aorta in the normal fashion to join the right IVC. In variant forms, the interruption of the intrahepatic segment of the IVC, azygos or hemiazygos continuation, or retroaortic course of the renal vein may be seen. An intrahepatic venous shunt accompanying a double IVC variant is an extremely rare anomaly. We report a case of 40-year-old female patient with double IVC, hemiazygos continuation, intrahepatic IVC interruption, and a transhepatic venous shunt.

To evaluate the characteristics of images generated by magnetic resonance imaging (MRI) and changes in the mass-like lesion (MLL) during the follow-up of patients who underwent partial nephrectomy (PN) with the intra-operative use of hemostatic agents (HAs). The records of patients who had undergone PN in our clinic due to renal mass between January 2013 and August 2018 were retrospectively reviewed. Our study included 47 patients who were administered one or more HAs during the PN and who received diffusion and dynamic MRI at the post-operative 2nd/4th Queryand 12th month. MLL is defined as T2 heterogeneous, intermediate-signal intensity bolster-related mass with a pseudocapsule in the renal parenchymal defect. When we looked at the morphological changes of MLL, the mean largest axial dimensions of masses were 27.3 (range 12.2–44.7) mm in the first follow-up period (2nd/4th months) and 21.2 (range 11–44.7) mm in the 12th month follow-up period. The average change in size of MLL was − 0.66 mm/month. We did not see any significant relationship between observation of MLL in the post-operative follow-up MRI images and the use of HAs such as Surgicel®, Spongostan®, and autologous fatty tissue as well as the amount of the agents used in PN operations (p = 0.405, p = 0.159, respectively). The distinction of MLL causing bolster-related mass and granulomatosis tissue from relapse/recurrence can be made based on the change in mass size observed in the MR images and image characteristics.

Objective To compare the utility of computed tomography perfusion (CTP) and three different 4-point scoring systems in computed tomography angiography (CTA) in confirming brain death (BD) in patients with and without skull defects. Materials and Methods Ninety-two patients clinically diagnosed as BD using CTA and/or CTP for confirmation were retrospectively reviewed. For the final analysis, 86 patients were included in this study. Images were re-evaluated by three radiologists according to the 4-point scoring systems that consider the vessel opacification on 1) the venous phase for both M4 segments of the middle cerebral arteries (MCAs-M4) and internal cerebral veins (ICVs) (A60-V60), 2) the arterial phase for the MCA-M4 and venous phase for the ICVs (A20-V60), 3) the venous phase for the ICVs and superior petrosal veins (ICV-SPV). The CTP images were independently reviewed. The presence of an open skull defect and stasis filling was noted. Results Sensitivities of the ICV-SPV, A20-V60, A60-V60 scoring systems, and CTP in the diagnosis of BD were 89.5%, 82.6%, 67.4%, and 93.3%, respectively. The sensitivity of A20-V60 scoring was higher than that of A60-V60 in BD patients (p < 0.001). CTP was found to be the most sensitive method (86.5%) in patients with open skull defect (p = 0.019). Interobserver agreement was excellent in the diagnosis of BD, in assessing A20-V60, A60-V60, ICV-SPV, CTP, and good in stasis filling (κ: 0.84, 0.83, 0.83, 0.83, and 0.67, respectively). Conclusion The sensitivity of CTA confirming brain death differs between various proposed 4-point scoring systems. Although the ICV-SPV is the most sensitive, evaluation of the SPV is challenging. Adding CTP to the routine BD CTA protocol, especially in cases with open skull defect, could increase sensitivity as a useful adjunct.

Summary Objective Calyceal diverticulum (CD) is rarely diagnosed in children. It mimics other cystic lesions of the kidney and may be very difficult to identify. Displaying the communication of these fluid-filled cavities with the collecting system of the kidney via imaging methods is the key diagnostic method. The purpose of this study is to determine the presence of calyceal diverticulum in pediatric patients followed up due to simple renal cyst and/or parapelvic cyst. Material, and method Patients who were newly diagnosed or being followed up with the ultrasonographic diagnosis of simple cyst(s) or parapelvic cyst(s) in the Department of Pediatric Nephrology of Izmir University of Health Sciences Tepecik Training and Research Hospital between December 2015 and July 2018 were included in the study. Age, gender, admission symptoms, recurrent urinary tract infections, stone disease, trauma history, accompanying urinary system and systemic anomalies, localization, and size of the cyst(s) at admission and during follow-up, treatment type and developing complications were noted. Contrast MR urography was applied to all patients. Results A total of 43 patients [mean age:132 ± 54.9 (12–228) months] including 25 girls were enrolled in the study. The mean follow-up period was 36. 74 ± 19 (1–90) months. The cysts were located mostly in the right kidney and also in the upper pole of the kidney. The mean cyst size was 20.4 ± 11 (8–58) mm at admission, and comparably 20.3 ± 8.6 (10–45) mm at the end of the follow-up. In contrast MR urography, a total of 16 cases were observed at first glance to be associated with pelvicalyceal system. However, in the postcontrast images taken at the 5th minute it was determined that 9 of them were compatible with calyceal diverticulum. Conclusion Although it is thought that well-circumscribed solitary renal fluid collections may be thought to be a simple renal cyst at first glance, the differential diagnosis of calyceal diverticulum (CD) should be absolutely kept in mind. Contrast studies and late-phase postcontrast images are needed for the diagnosis of CD. Although the standard management of CDs in children is conservative, surgical intervention may be rarely required. Download : Download high-res image (246KB) Download : Download full-size image

ObjectiveThe aim of this retrospective single-center study was to evaluate the relationship between maximum tumor size, tumor volume, tumor volume ratio (TVR) based on preoperative magnetic resonance (MR) volumetry, and negative histological prognostic parameters (deep myometrial invasion [MI], lymphovascular space invasion, tumor histological grade, and subtype) in International Federation of Gynecology and Obstetrics stage I endometrial cancer.Methods/MaterialsPreoperative pelvic MR imaging studies of 68 women with surgical-pathologic diagnosis of International Federation of Gynecology and Obstetrics stage I endometrial cancer were reviewed for assessment of MR volumetry and qualitative assessment of MI. Volume of the tumor and uterus was measured with manual tracing of each section on sagittal T2-weighted images. Tumor volume ratio was calculated according to the following formula: TVR = (total tumor volume/total uterine volume) × 100. Receiver operating characteristics curve was performed to investigate a threshold for TVR associated with MI. The Mann-Whitney U test, Kruskal-Wallis test, and linear regression analysis were applied to evaluate possible differences between tumor size, tumor volume, TVR, and negative prognostic parameters.ResultsReceiver operating characteristics curve analysis of TVR for prediction of deep MI was statistically significant (P = 0.013). An optimal TVR threshold of 7.3% predicted deep myometrial invasion with 85.7% sensitivity, 46.8% specificity, 41.9% positive predictive value, and 88.0% negative predictive value. Receiver operating characteristics curve analyses of TVR, tumor size, and tumor volume for prediction of tumor histological grade or lymphovascular space invasion were not significant. The concordance between radiologic and pathologic assessment for MI was almost excellent (κ value, 0.799; P < 0.001). Addition of TVR to standard radiologic assessment of deep MI increased the sensitivity from 90.5% to 95.2%.ConclusionsTumor volume ratio, based on preoperative MR volumetry, seems to predict deep MI independently in stage I endometrial cancer with insufficient sensitivity and specificity. Its value in clinical practice for risk stratification models in endometrial cancer has to be studied in larger cohort of patients.

Introduction: Intracytoplasmic sperm injection (ICSI) currently helps many couples with male infertility. However, ICSI procedure may cause asynchronous sperm decondensation. This could introduce a risk for aneuploidy. The ICSI technique also could cause damage to the second meiotic spindle during injection and cause significantly abnormal pairing of chromosomes when compared with in vitro fertilization (IVF). In this study, we have examined whether ICSI has a higher incidence of aneuploidy when compared with IVF.Material and Methods: A retrospective study was conducted on 36 individuals. Common numbers of chromosome abnormalities were detected using fluorescent in-situ hybridization (FISH). Seven probes were used to detect chromosome X, Y, 13, 16, 18, 21, and 22. Chi-square test was used for statistical analysis and presented as odd ratios with confidence intervals.Results: The age range was 26 through 44 (mean age 35.5) for IVF and 25 through 46 (mean age 35.8) for ICSI. From the 36 egg retrievals, 57 embryos were obtained from nine individuals using IVF and 183 embryos were obtained from 27 individuals using ICSI. For the IVF group, 37 of the 57 examined embryos were abnormal (65%), whereas 128 of 183 examined embryos were abnormal for the ICSI group (69.9%). Among the 57 embryos from the IVF cases, the number of absolute abnormal chromosomes were as follows: X&Y chromosomes: 4 (12.9%), chromosome 13: 9 (29%), chromosome 16: 7 (22.5%), chromosome 18: 6 (19.3%), chromosome 21: 8 (25.8%), chromosome 22: 10 (32.2%). For the ICSI embryos: X and Y chromosomes: 18 (14%), chromosome 13: 34 (26.5%), chromosome 16: 23 (18%), chromosome 18: 23 (18%), chromosome 21: 26 (20.3%), chromosome 22: 31 (24.2%). The odds ratios for the difference between IVF and ICSI for each chromosome were as follows: X&Y chromosomes: 1.53 (0.598-3.916), chromosome 13: 0.969 (0.443-2.122), chromosome 16: 0.709 (0.307-1.639), chromosome 18: 1.650 (0.650-4.188), chromosome 21: 0.777 (0.350-1.724), chromosome 22: 0.647 (0.311-1.348). Overall no significant difference between two insemination procedures was seen 0.948 (0.678-1.324).Conclusions: As a result; ICSI does not create a significantly higher aneuploidy number when compared with IVF as examined by FISH analysis of seven chromosome pairs.Keywords: Aneuploidy, infertility, ICSI, IVF, fluorescent in-situ hybridization

The effects of trauma in children are different due to association with some anatomical and physiological differences compared with adults. The role of neuroimaging gains importance in early detection of traumatic brain injuries and prevention of secondary post-traumatic complications. Many algorithms are described for children with head trauma to decide the necessity of a computed tomography scan. The aims of this article are to describe differences of these algorithms, the mechanism of traumatic brain injury with radiological imaging findings in the pediatric population, and explain complications of undiagnosed traumatic brain lesions.

The glenoid version is an important factor in the etiology of anterior dislocation of the shoulder and the planning of shoulder surgery. Few reports compare the magnetic resonance imaging (MRI) measurements of the glenoid version with those of computed tomography (CT). This study aimed to show that it is possible to use MRI instead of CT, which is accepted as the gold standard today for the evaluation of the glenoid version. A total of 55 patients with a history of 1 nonsurgically treated unilateral anterior dislocation of the shoulder who had both MRI and CT records for the dislocated shoulders constituted the study group. The glenoid version was measured in the axial plane on MRI and CT. Mean glenoid version measured by the observers was −1.6°±4.7° (95% confidence interval, −2.3° to −0.8°) and −1.8°±4.3° (95% confidence interval, −2.5° to −1.2°) by CT and MRI, respectively ( P =.126). The evaluation of the CT and MRI measurements made by the 3 observers (X, Y, and Z) revealed no significant difference, as the P values of X CT - X MRI, Y CT - Y MRI, and Z CT - Z MRI were .550, .406, and .238, respectively. Interclass correlation among the 3 observers for CT and MRI was 0.996 and 0.981, respectively. The imaging methods of MRI and CT can be interchangeably used in the evaluation of the glenoid version in cases of anterior dislocation of the shoulder. [ Orthopedics. 2017; 40(4):e687–e692.]

Purpose: We assessed the prevalence of the clinically important posterior fossa emissary veins detected on computed tomography (CT) angiography. Materials and Methods: A total of 182 consecutive patients who underwent 64-slice CT angiography were retrospectively reviewed to determine the clinically important posterior fossa emissary veins. Results: Of 166 patients, the mastoid emissary vein (MEV) was not identified in 37 (22.3%) patients. It was found bilaterally in 82 (49.4%) and unilaterally in 47 (28.3%) patients. Only six patients had more than one MEV that were very small (5 mm) veins. The posterior condylar vein (PCV) was not identified in 39 (23.5%) patients. It was found bilaterally in 97 (58.4%) and unilaterally in 30 (18.1%) patients. Only 15 patients had a very large (>5 mm) PCV. The petrosquamosal sinus (PSS) was identified only in one patient (0.6%) on the left side. The occipital sinus was found in two patients (1.2%). Conclusions: The presence of the clinically important posterior fossa emissary veins is not rare. Posterior fossa emissary veins should be identified and systematically reported, especially prior to surgeries involving the posterior fossa and mastoid region.

Background Although increased retroversion of the glenoid has been shown to be an important factor in posterior instability of the shoulder, there are few studies reporting glenoid bone structure as a risk factor in anterior dislocation of the shoulder. This study aimed to compare glenoid version in patients with anterior dislocation of the shoulder and individuals in a control group with no shoulder problems before undergoing computed tomography and to assess a possible relationship between demographic characteristics and glenoid version angle. Methods The study group comprised 63 patients (12 women and 51 men; mean age, 35.71 years) with 1 or multiple unilateral anterior dislocations of the shoulder (dislocated group), whereas 63 individuals (11 women and 52 men; mean age, 35.38 years) with no history of shoulder complaints and no signs of instability constituted the control group. The glenoid version angle was measured on an axial cut of the computed tomography scan. Results The glenoid version angles on the dislocated side in the study group were significantly more anteverted than those of the dominant ( P P = .023) shoulders of the control group. The version angles of dislocated shoulders significantly differed from those of nondislocated shoulders of both men ( P = .041) and women ( P = .049). There was no significant relationship between the glenoid version angle on the dislocated side and dislocation mechanism ( P = .883), age group ( P = .356), or number of dislocations ( P = .971). Conclusions Glenoid version is an important factor for the development of anterior dislocation of the shoulder.

Background: It is important to know whether or not the stroke risk factors and etiologies of patients with multiple acute infarcts are different to those of patients with a single acute infarct. Aim: The frequency of multiple acute infarct was investigated in ischemic stroke patients and a comparison was made of the characteristics of stroke patients with and without multiple acute infarct. Patients and Methods: We reviewed the clinical records of 988 ischemic stroke patients who were admitted within 1 week of the onset of stroke and diffusion-weighted imaging (DWI) was performed on first presentation. The clinical characteristics, laboratory, and imaging results were noted from the patient records. According to the DWI findings, the patients were separated into three groups as those with a single acute infarct in a single vascular territory (SI group), those with multiple acute infarcts in a single vascular territory (SMI group) and those with multiple acute infarcts in multiple vascular (MMI group) territories. The frequency of multiple acute infarcts was investigated, and a comparison was made of the characteristics of stroke patients with and without multiple acute infarcts. Results: The SMI group included 119 (12%) patients and the MMI group 126 (12.8%). The most common mechanisms of multiple acute infarcts are large artery atherosclerosis and cardiac origin emboli. Moreover, the risk factors most determined were hypertension, diabetes mellitus, and hyperlipidemia in the MMI group. Conclusion: No difference was determined between the groups in respect of stroke etiology and risk factors.

Developmental venous variations (DVVs) are anatomic variations of normal transmedullary veins which are often discovered incidentally. Although they are accepted as benign compensatory venous drainage systems, they may become symptomatic or clinically significant due to flow-related causes. The fragile venous drainage systems increase vulnerability to in-out flow alterations. Increased inflow or decreased outflow causes rise in venous pressure, which may subsequently produce ischemic symptoms. Obstruction or stenosis of the collector vein is the most common cause of decreased outflow of a DVV. However, in the absence of collecting vein stenosis, venous hypertension may still exist due to volume overload. In case of multiple DVVs with single combined drainage pathway, functional outflow restriction may occur due to diminished capability of the vessel to adapt to pressure changes. In this report, we present a case with bilateral thalamic DVVs, which cause parenchymal amorphous calcification and drain into the left internal cerebral vein. A review of the literature on DVVs with outflow restriction including pathophysiological mechanisms is also discussed.

Mature cystic teratoma (MCT) is the most common neoplasm of the ovary and includes at least two well- differentiated germ cell layers. Different combinations of mature tissue derivatives with varying arrangements in the tumour cause a wide spectrum of radiological presentation ranging from a purely cystic mass to a complex cystic mass with a considerable solid component. In different imaging modalities, each radiological feature reflects a specific pathologic equivalent that forms because of diverse compositions of histological components. Understanding uncommon findings as well as the classic signs with basic knowledge of pathological equivalents permits a more accurate diagnosis and guides adequate treatment. In this review, radiological features of MCT in different imaging modalities (US, CT, MR imaging) including specific signs and useful radiological artefacts with brief emphasis on pathological basics are discussed. Teaching points • Ovarian mature cystic teratomas (MCTs) have a wide spectrum of radiological presentation. • Each radiological feature of MCT reflects a specific pathologic equivalent. • Understanding radiological signs with basic knowledge of pathology can permit a more accurate diagnosis.