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Pediatric Radiology
Published in: Pediatric Radiology 9/2016

01-08-2016 | Original Article

Simulated impact of pelvic MRI in treatment planning for pediatric adnexal masses

Authors: Alessandro Marro, Lisa M. Allen, Sari L. Kives, Rahim Moineddin, Govind B. Chavhan

Published in: Pediatric Radiology | Issue 9/2016

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Abstract

Background

There are no studies on utility of MRI in management of pediatric adnexal masses.

Objective

To determine the diagnostic and therapeutic impact of pelvic MRI in adnexal masses in children and adolescents.

Materials and methods

We included 32 females age 18 years and younger who had adnexal masses and who underwent both pelvic ultrasound (US) and MRI. A radiologist retrospectively reviewed US and MR images and created a standard radiologic report for each patient. In a prospective theoretical fashion, two pediatric gynecologists reviewed the clinical data and US report for each patient and indicated conservative versus surgical management; in surgical cases the options were laparoscopy versus laparotomy, midline versus Pfannenstiel incision, and oophorectomy versus cystectomy. Subsequently, the gynecologists were presented the MRI report and were asked to indicate their treatment options again. A binomial test was conducted to determine the effect of adding MRI findings to the management plan.

Results

The addition of MRI significantly changed management in 10 of 32 patients (P=0.0322), with a change in surgical versus conservative treatment in 5, a change in laparotomy vs. laparoscopy in 2, and a change from oophorectomy to cystectomy along with change in incision in 3 cases. This was based on additional information provided by MRI regarding the nature of the mass in 8 cases and origin of the mass in 2 cases.

Conclusion

Preoperative pelvic MRI findings might change the surgical management of pediatric patients with adnexal masses, so it is a valuable addition to the conventional workup in the clinical management.
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Metadata
Title
Simulated impact of pelvic MRI in treatment planning for pediatric adnexal masses
Authors
Alessandro Marro
Lisa M. Allen
Sari L. Kives
Rahim Moineddin
Govind B. Chavhan
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 9/2016
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-016-3606-y

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