Figure 11d. Tuberculous TOA in a 52-year-old woman. (a) Unenhanced CT scan shows a right adnexal mass (white arrows) with multiple internal calcifications (black arrows). (b) Contrast-enhanced CT scan shows that the adnexal mass (white arrows) is predominantly cystic with an irregular, thick, well-enhancing wall. In addition, a lobulated cystic mass (black arrows) with thin internal septa is seen posterior to the adnexal mass. The solid mass in the left adnexal region (arrowheads) is an incidentally found ovarian Brenner tumor. (c) Sagittal T2-weighted MR image shows low signal intensity of the wall and septa of the right adnexal mass (white arrows). Note the small nodular lesions along the inner wall (black arrows). (d, e) Sagittal contrast-enhanced T1-weighted MR images show marked enhancement of the wall and septa of the right adnexal mass (white arrows in d). Adhesion to the uterus (U) is clearly demonstrated (black arrows in d). In addition, a multiseptate cystic lesion (arrows in e) is seen in the cul-de-sac.