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O-RADS ACR Ovarian-Adnexal Reporting and Data System (Ultrasound)                                     

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Complete evaluation is generally based on transvaginal sonography, although they may be augmented by transabdominal or transrectal sonography as needed. Incomplete evaluation is likely due to technical factors such as bowel gas, large size of the lesion, location of the adnexa, or inability to tolerate endovaginal imaging.

Each patient should be categorized as pre- or postmenopausal with the postmenopausal category defined as amenorrhea of greater than or equal to 1 year. If the menopausal status is unknown, SRU consensus suggests 50 years of age can be used as an arbitrary designation for the age of menopause. A patient up to 50 years of age is considered as premenopausal. A patient >=50 years of age is considered postmenopausal.

The size of the lesion should be obtained by measuring the largest diameter of the lesion regardless of the plane in which that diameter appears.

In cases of multiple or bilateral lesions, each lesion should be separately characterized, and management driven by the lesion with the highest O-RADS score.

Normal physiological findings in premenopausal women include follicles (unilocular, anechoic simple cyst, <=3 cm) and corpus luteum (thick-walled cyst <=3 cm with or without crenulated inner margin, internal echoes or peripheral flow OR hypoechoic region with peripheral flow only but without characteristic cystic component).