 Today, I Dr. Shradha Joshi, PG resident in the Department of Radio Diagnosis at ABVIMS in Dr. R. M. Hospital New Delhi. I am presenting an oral paper on the comparison of ultrasound and MRI orats. The co-author of this paper is Dr. Kavita Vani, who is a consultant in the Department of Radio Diagnosis at ABVIMS in Dr. R. M. Hospital New Delhi. Introduction. At Nexel masses are the most common kinemiological disorders. They include lesions arising from the ovaries, fallopian tubes, broad ligament and adjacent neurovascular. Ovarian tumors are the most common at Nexel masses. Noninvasive imaging modalities include pelvic ultrasound, CT and MRI. However, the gold standard for diagnosis is histopathological evaluation of the leprotomy specimen. Pelvic ultrasound is the initial imaging modality for evaluation of at Nexel masses. It is low-cost accessible, does not carry radiation hazard and can be repeated multiple times without any adverse effects, making it optimal for follow-up. However, it is operator dependent and is limited by body habitus and acoustic windows. Pelvic MRI is the investigation of choice for evaluation of at Nexel masses. It has better spatial and tissue resolution, does not carry radiation risk and has high accuracy in characterization of mass and staging of malignancy. However, it is a high-cost modality with limited availability and carries a risk of contrast reactions. Aim of our study is to evaluate the benefit of ultrasound orats as compared to MRI orats methodology. This was a prospective cross-section study conducted in the Department of Radio Diagnosis at AVVIMS and Dr. R. M. Hospital in Delhi. 30 consecutive patients were referred to the Department of Radio Diagnosis over a course of four months were evaluated by ultrasound and MRI. Pelvic ultrasound was conducted in a moderately distended bladder using alpinoin E-cube machine with a low-frequency curvilinear probe and pelvic contrast-enhanced MRI was conducted using Siemens Skyra 3D MRI machine. Results, age of the patients ranged from 17 to 65 years with a mean age of 35.6 years. 22 females were pre-menopausal and 8 females were post-menopausal. The most common lesion identified on ultrasound was a follicular cyst in 9 patients and the most common USU orats category assigned was ORAS 1 in 10 patients. This is a tabular representation of the adnexal lesions identified on ultrasound and MRI. In this study, the sensitivity of ultrasound was compared to that of MRI. Follicular cysts were identified in 9 patients. Hemorrhagic cysts in 4 patients and corpus luteal cysts in 1 patient. Out of the 7 patients with unilock東 cysts, 2 patients had cyst with internal septal 2 patients had cyst with internal solid components and 3 patients had cysts without any internal septal or solid components. Out of the 4 patients with multi-local cysts identified on an ultrasound, 3 patients had multi-local cysts without solid component and 1 patient had cyst with solid component. 2 adnexal solid lesions and 2 hydroxylphines would also identified an ultrasound. This is a comparison of ORATS category assigned on ultrasound and MRI. As we can see, 10 patients were diagnosed as ORATS category 1 lesions on both ultrasound and MRI. One patient with ORATS category 2 on ultrasound was upgraded to ORATS category 3 on MRI. Two patients with ORATS category 3 on ultrasound were upgraded to ORATS category 4 on MRI. One patient with ORATS category 4 was upgraded to ORATS category 5 on MRI. Both ultrasound and MRI could diagnose four patients with ORATS category 5 lesions. Causes for upgradation of ORATS category on MRI included size and number of papillary projections in unilocalysis, presence of solid component in unilocalysis, and wall enhancement and type of dynamic contrast enhancement curve on MRI. Coming to ORATS category 1 lesions, the type of lesions included a follicular cyst less than 3 cm in 9 patients and a corpus gluteal cyst less than 3 cm in 1 patient. This is an axial ultrasound image depicting bulky right ovary with a follicular cyst and an adjacent simple cyst with internal eco suggestive of a hemorrhagic cyst. Coming to ORATS category 2 lesions, the type of lesions included a simple cyst less than 10 cm in 1 patient, a typical endometrioma in 1 patient, a typical peritoneal inclusion cyst in 1 patient, and a typical hydrosulpins in 2 patients. The first image is an adnexa lesion depicting a cyst with internal ecosynseptations giving it a fishnet appearance suggestive of a hemorrhagic cyst and the second set of images are axial ultrasound and corresponding post-contrast MR image depicting a dilated tubular structure suggestive of hydrosarpings on the left side and a well-defined heteroequic lesion in the right adnexa suggestive of tubovirian axis. Coming to ORATS category 3, the lesions included were simple cyst more than 10 cm in 1 patient, a unilocular cyst with irregular inner wall less than 3 mm in 1 patient, typical peritoneal inclusion cyst more than 10 cm in 1 patient, and a multi-locular cyst in 3 patients. This is an ultrasound and corresponding P2 axial coronal and sedytal image of a multi-locular cyst with internal septations. Coming to ORATS category 4, the type of lesions included a unilocular cyst less than 3 papillary projections in 1 patient, a multi-locular cyst with solid component with a color score 2 in 1 patient, a multi-locular cyst with irregular walls and internal septations in 1 patient, and a solid lesion with a color score of 2 in 1 patient. This is an ultrasound and corresponding post-contrast MR image depicting a multi-locular cyst in the left ovary with internal septations. Coming to ORATS category 5, the lesions included were a unilocular cyst with more than 3 papillary projections in 1 patient, a multi-locular cyst with solid component with a color score of 3 in 1 patient, a solid lesion with a color score of 4 in 1 patient and a cytosine peritoneal nodules in 1 patient. These are the USG images depicting a complex cyst in the right and next up with internal septations in solid components and a solid cystic lesion in the left ovary with overdine peritoneal nodules. This is an ultrasound image in the same patient depicting a hyper-equic lesion in the liver with separated cysts. This is a coronal post-contrast MR image of the same patient depicting a bulky right ovary with an adjacent cystic lesion with enhancing walls in multiple papillary projections. Discussion. Ovarian tumors represent the most common adnex lesions. Although ultrasound is the initial imaging modality for evaluation, it is operated dependent and may be limited by acoustic windows. MRI has a high spatial and tissue resolution with a high accuracy in identifying tissue of lesion, characterization of lesions and pre-operative planning. Ultrasonic was limited in the evaluation of origin of adnexil masses, internal septations in solid components and internal vascularity. Few lesions were upgraded on MRI or ads based on the number of papillary projections, the height of solid components and the type of enhancement probe on dynamic imaging, wall enhancement and contents of hydrosulfates. This is in accordance with previous studies which state that MR has a high accuracy in evaluation and characterization of adnexil masses. Our study was limited by the small sample size and selection bias. Inclusion. The most common adnexil mass in our study was a follicular cyst followed by a unilocal cyst. The most common ORADS category assigned was ORADS1. In few lesions, ORADS category was upgraded at MRI based on morphological characteristics and enhancement characteristics. MRI has a higher sensitivity than ultrasound in the evaluation of origin and characterization of adnexil masses. These are my references. Thank you.