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Ovarian Lesions with Hypointensity on T2-Weighted Magnetic Resonance Imaging

Low T2-weighted signal on magnetic resonance imaging (T2WI) in a solid ovarian lesion is usually secondary to fibrous tissue or blood products. It is usually a sign of benignity. The exception is a Krukenberg tumor. Bilaterality and prominent enhancement would suggest a Krukenberg tumor.¹ Endometriomas are characteristically hypointense on T2. Other ovarian lesions that are hypointense on T2WI are Brenner tumors, fibromas, and fibrothecomas, and cystadenofibromas.

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