Figure 6a. Tubo-ovarian actinomycosis in a 48-year-old woman. The TOA has a solid and cystic appearance. (a) Axial T2-weighted MR image shows a solid and cystic mass in the right adnexal region (black arrows). Note the posterior extension by a solid lesion with low signal intensity (white arrows). (b) Axial contrast-enhanced fat-suppressed T1-weighted MR image obtained caudad to a shows good enhancement of the solid portion of the mass, which has multiple internal rim-enhancing lesions (black arrow). The linear, solid lesion extending posteriorly from the mass (white arrows) is also well enhanced.