卵巢癌组织学类型的术前评估对于确定适当的治疗策略至关重要。肿瘤位置可能在此方面有所帮助。本研究的目的是比较通过MRI评估子宫内膜异位症相关卵巢癌（EAOCs）和非相关卵巢癌（非EAOCs）相对于子宫的位置。回顾性研究包括在2015年1月至2023年1月期间在我院接受MRI的经病理证实为恶性上皮性卵巢肿瘤的患者。分析使用了子宫体长轴矢状位和轴位的T2加权图像。三位瞎掉的经验丰富的放射科医师独立解读图像，并评估卵巢肿瘤是否与子宫相连，并测量子宫与肿瘤之间的角度。对于每种组织学，比较了相连的情况和测量的角度。此外，比较了EAOCs（包括子宫内膜样癌（ECs）和透明细胞癌（CCCs））与非EAOCs之间的角度。 共评估了184名女性（平均年龄56岁，年龄范围20-91岁）。高级浆液性癌（HGSCs）的大小显著小于其他类型，并且与CCC相比与子宫有显著较少的连接（p <0.01，对于所有读者都是如此）。根据测量角度的平均值，CCC相对于HGSCs和粘液性癌定位更后位置（p <0.02），而EAOCs明显位于非EAOCs之后（p <0.01）。 HGSCs通常不与子宫相连，而EAOCs相对于非EAOCs更靠后地位于子宫后方。 • 可以使用MRI确定卵巢肿瘤的位置。 • 高级浆液性癌与子宫的连接较少。 • 子宫内膜异位症相关癌位于子宫后部位置。 • 卵巢肿瘤的位置有助于估计组织学。 © 2023. 欧洲放射学会（ESR）。

Preoperative assessment of the histological type of ovarian cancer is essential to determine the appropriate treatment strategy. Tumor location may be helpful in this regard. The purpose of this study was to compare the position of endometriosis-associated (EAOCs) and non-associated (non-EAOCs) ovarian cancer relative to the uterus using MRI.This retrospective study included patients with pathologically confirmed malignant epithelial ovarian tumors who underwent MRI at our hospital between January 2015 and January 2023. T2-weighted images of the sagittal and axial sections of the long axis of the uterine body were used for the analysis. Three blinded experienced radiologists independently interpreted the images and assessed whether the ovarian tumor was attached to the uterus, and the angle between the uterus and the tumor was measured. The presence of attachment and the measured angles were compared for each histology. In addition, the angles between EAOCs, including endometrioid carcinomas (ECs) and clear cell carcinomas (CCCs), were compared with non-EAOCs.In total, 184 women (mean age, 56 years; age range, 20-91 years) were evaluated. High-grade serous carcinomas (HGSCs) were significantly smaller than the others and had significantly less uterine attachment than CCCs (p < 0.01 for all readers). According to the mean of the measured angles, CCCs were positioned significantly more posteriorly than HGSCs and mucinous carcinomas (p < 0.02), and EAOCs were positioned significantly more posteriorly to the uterus than non-EAOCs (p < 0.01).HGSCs are often not attached to the uterus, and EAOCs are positioned more posteriorly to the uterus than non-EAOCs.High-grade serous carcinomas were often not attached to the uterus, and endometriosis-associated ovarian cancers were positioned more posteriorly to the uterus than non-endometriosis-associated ovarian cancers.• The position of the ovarian tumor can be determined using MRI. • High-grade serous carcinomas had less attachment to the uterus. • Endometriosis-associated cancers were positioned more posteriorly to the uterus. • The location of ovarian tumors is helpful in estimating histology.© 2023. European Society of Radiology (ESR).