Figure 1.

A 61-year-old female patient with an ovarian granulosa cell tumor. (A) Axial T2WI revealed a cystic solid mass in the right adnexal region that manifested with a “spongy” or “honeycomb” change (white arrow). (B) Sagittal T2WI showed thickening of the endometrium to a thickness of approximately 1.9 cm. (C) Axial T1WI revealed a cystic solid mass with a hypo–isointense signal. (D) On contrast-enhanced fat-suppressed T1WI, the solid components (red arrow) of the lesion showed mild and moderate enhancement, with a region resembling the myometrium. (E) On DWI-MRI (b = 1,000 s/mm²), the solid part of the lesion appeared hyperintense (yellow arrow), and the cystic part appeared hypointense. (F) The apparent diffusion coefficient (ADC) map showed that the average ADC value of the diffuse high-signal area was approximately 0.7 × 10^-3 mm²/s. (G) Hematoxylin and eosin (H&E) staining (×100) showed that the tumor cells appeared as large islands, diffusely distributed in nests and rich in interstitial separation and blood vessels. (H) The texture analysis target area was delineated throughout the whole tumor layer by layer.