Imaging features of a mature teratoma of the ovary

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What are the imaging features of a mature teratoma of the ovary?

A mature teratoma on US is identified as a cystic or echogenic mass with distinct features such as thin, echogenic lines representing hair, posterior acoustic shadowing from calcifications including bone and teeth, and fluid-fluid levels from sebum layering with serous fluid.

On CT, fat attenuation with or without calcification is diagnostic for a mature teratoma. On MRI, high T1-weighted signal intensity may indicate the presence of fat or hemorrhage within a mass.

Using fat suppression techniques on MRI, one can differentiate a mature teratoma from a hemorrhagic cyst or endometrioma, as the former will lose signal intensity on fat-suppressed T1-weighted images, whereas the latter will not.

Mature teratoma can be associated with complications such as torsion (common), malignant degeneration (rare, <2%), or rupture (rare <1%), sometimes with associated chemical peritonitis.

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