This prospective study aims to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in characterizing adnexal cystic lesions and differentiating benign from malignant lesions. MRI findings will be correlated with histopathology, surgical data, laboratory results, or follow-up imaging when surgery is not performed, to improve diagnostic confidence and guide appropriate patient management.

Adnexal cystic lesions are commonly encountered in gynecologic imaging and may represent a spectrum of benign and malignant conditions. While ultrasound is the first-line imaging modality due to its accessibility and safety, many adnexal masses remain indeterminate.

Magnetic resonance imaging (MRI) provides superior soft-tissue contrast and multiparametric imaging, including T1-, T2-weighted sequences, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE), allowing better characterization of adnexal lesions. Features such as solid tissue, papillary projections, thick septa, and restricted diffusion help differentiate malignant from benign lesions.

This prospective study at Sohag University Hospital will include 50 female patients with adnexal cystic lesions detected on ultrasound. MRI findings will be correlated with histopathology, surgical data, laboratory results (CA-125), or follow-up imaging when surgery is not performed. The study aims to assess the diagnostic accuracy of MRI in differentiating benign from malignant adnexal lesions and to improve clinical decision-making regarding patient management.

Inclusion Criteria:

• Female patients of any age with adnexal cystic lesions detected by ultrasound
• Adnexal lesions that are indeterminate or suspicious on ultrasound
• Patients who provide written and oral informed consent

Exclusion Criteria:

• Patients unwilling to participate or complete the study
• Contraindications to MRI, including claustrophobia, metallic implants, pacemaker, or prosthetic heart valves

Only biologically female patients with adnexal cystic lesions are eligible, regardless of gender identity.

The study population will consist of 50 female patients of all ages presenting to the Radiology Department at Sohag University Hospital with adnexal cystic lesions detected on ultrasound. Eligible participants are those with indeterminate or suspicious ultrasound findings requiring further characterization with MRI. Patients will provide written and oral informed consent prior to inclusion.

Individual participant data will not be shared. All patient data will remain confidential and used solely for the purposes of this study.