Incidental Adnexal Finding on CT / MRI
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ACR IFC 2020·reviewed 2026-07-02
- •CT and non-dedicated MRI characterize adnexal lesions poorly. When a finding is not clearly a simple cyst below the size threshold, dedicated pelvic ultrasound (then O-RADS) is the next step.
- •Simple-cyst size thresholds mirror the SRU 2019 simple-cyst pathway; see the Simple Adnexal Cyst (Ultrasound) algorithm.
Appearance on CT / MRI?
Simple fluid = uniform water attenuation/signal, thin imperceptible wall, no solid component. Anything else = indeterminate.
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Sources
- Patel MD, et al. Management of Incidental Adnexal Findings on CT and MRI: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2020;17(2):248-254.
Educational reference for clinicians — not medical advice. Verify against the primary source before acting on it; guidelines change. Final decisions rest with the interpreting physician and your institution's protocols.