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Journal of Ovarian Research

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Open Access 01-12-2012 | Research

Evaluation of primary adnexal masses by 3T MRI: categorization with conventional MR imaging and diffusion-weighted imaging

Authors: He Zhang, Guo-Fu Zhang, Zhi-Yan He, Zheng-Yu Li, Ming Zhu, Gui-Xiang Zhang

Published in: Journal of Ovarian Research | Issue 1/2012

Abstract

Background

To investigate the 3.0-Tesla (3 T) magnetic resonance imaging (MRI) characteristics of primary adnexal lesions for discriminating benign from malignant lesions.

Methods

One hundred thirty-nine patients with pathologically proven primary adnexal masses referred for 3 T MRI assessment preoperatively were included. Baseline characteristics, components, and conventional MRI and diffusion-weighted imaging (DWI-MRI) signals were recorded and compared.

Results

There were 22 ovarian cysts, 33 endometriomas, 43 benign tumors and 42 malignant tumors. When ovarian cyst and endometrioma were excluded, there were no significant differences in patients’ age between benign and malignant tumor (P = 0.235). There were no significant differences (P = 0.606) in the conventional MRI signals and significant difference (P = 0.008) in DWI-MRI signal between the non-malignant and malignant lesions. There was a significant difference (P = 0.000) in the apparent diffusion coefficient values (ADCs) between the non-malignant and malignant lesions.

Conclusions

3 T MRI categorized the characteristics of primary adnexal lesions. Conventional MRI signals were not useful for characterizing between benign and malignant lesions. DWI-MRI and ADCs were helpful for distinguishing malignant from benign ovarian lesions.

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Myers ER BL, Havrilesky LJ, Cline KE, Terplan M, Kulasingam SL, Gray RN, McCrory DC: Management of Adnexal Mass. Evid Rep Technol Assess (Full Rep) 2006, 130: 1–145.

Rajkotia K, Veeramani M, Macura KJ: Magnetic Resonance Imaging of Adnexal Masses. Topics in Magnetic Resonance Imaging 2006, 17: 379–397. 10.1097/RMR.0b013e3180417d8ePubMedCrossRef

Griffin N, Grant LA, Sala E: Adnexal Masses: Characterization and Imaging Strategies. Seminars in Ultrasound, CT, and MRI 2010, 31: 330–346. 10.1053/j.sult.2010.07.002PubMedCrossRef

Hricak H, Chen M, Coakley FV, et al.: Complex Adnexal Masses: Detection and Characterization with MR Imaging—Multivariate Analysis1. Radiology 2000, 214: 39–46.PubMedCrossRef

Sohaib SA, Mills TD, Sahdev A, et al.: The role of magnetic resonance imaging and ultrasound in patients with adnexal masses. Clinical Radiology 2005, 60: 340–348. 10.1016/j.crad.2004.09.007PubMedCrossRef

Chilla B, Hauser N, Singer G, Trippel M, Froehlich J, Kubik-Huch R: Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions. European Radiology 2011, 21: 1301–1310. 10.1007/s00330-010-2018-xPubMedCrossRef

Bakir B, Bakan S, Tunaci M, et al.: Diffusion-weighted imaging of solid or predominantly solid gynaecological adnexial masses: is it useful in the differential diagnosis? British Journal of Radiology 2011, 84: 600–611. 10.1259/bjr/90706205PubMedCentralPubMedCrossRef

Levy A, Medjhoul A, Caramella C, et al.: Interest of diffusion-weighted echo-planar MR imaging and apparent diffusion coefficient mapping in gynecological malignancies: a review. Journal of Magnetic Resonance Imaging 2011, 33: 1020–1027. 10.1002/jmri.22546PubMedCrossRef

Thomassin-Naggara I, Darai E, Cuenod CA, et al.: Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses. European Radiology 2009, 19: 1544–1552. 10.1007/s00330-009-1299-4PubMedCrossRef

10.

Takeuchi M, Matsuzaki K, Kubo H, Nishitani H: Magnetic Resonance Manifestations of Endometrial Cysts at 3 T Compared With 1.5 T. Journal of Computer Assisted Tomography 2008, 32: 369–371. 10.1097/RCT.0b013e318123e872PubMedCrossRef

11.

Kaneda S, Fujii S, Fukunaga T, et al.: Myometrial invasion by endometrial carcinoma: evaluation with 3.0 T MR imaging. Abdominal Imaging 2011, 36: 612–618. 10.1007/s00261-011-9719-8PubMedCrossRef

12.

Komatsu T, Konishi I, Mandai M, et al.: Adnexal masses: transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure. Radiology 1996, 198: 109–115.PubMedCrossRef

13.

Grab D, Flock F, Stöhr I, et al.: Classification of Asymptomatic Adnexal Masses by Ultrasound, Magnetic Resonance Imaging, and Positron Emission Tomography. Gynecologic Oncology 2000, 77: 454–459. 10.1006/gyno.2000.5768PubMedCrossRef

14.

Rieber A, Nüssle K, Stöhr I, et al.: Preoperative Diagnosis of Ovarian Tumors with MR Imaging. American Journal of Roentgenology 2001, 177: 123–129.PubMedCrossRef

15.

Funt SA, Hann LE: HL. Detection and characterization of adnexal masses. Radiol Clin North Am. 2002, 40: 591–608. 10.1016/S0033-8389(01)00009-4PubMedCrossRef

16.

Sohaib SAA, Sahdev A, Trappen PV, Jacobs IJ, Reznek RH: Characterization of Adnexal Mass Lesions on MR Imaging. American Journal of Roentgenology 2003, 180: 1297–1304.PubMedCrossRef

17.

Lee EJ, Kim SH, Kim YH, Lee HJ: Is CA-125 an additional help to radiologic findings for differentiation borderline ovarian tumor from stage I carcinoma? Acta Radiologica 2011, 52: 458–462. 10.1258/ar.2011.100318PubMedCrossRef

18.

Moyle P, Addley HC, Sala E: Radiological Staging of Ovarian Carcinoma. Seminars in ultrasound, CT, and MR 2010, 31: 388–398. 10.1053/j.sult.2010.07.003PubMedCrossRef

19.

Shaaban A, Rezvani M: Ovarian Cancer: Detection and Radiologic Staging. Clinical Obstetrics and Gynecology 2009, 52: 73–93. 10.1097/GRF.0b013e3181961625PubMedCrossRef

20.

Togashi K: Ovarian cancer: the clinical role of US, CT, and MRI. European Radiology 2003, 13: L87-L104. 10.1007/s00330-003-1964-yPubMedCrossRef

21.

Bazot M, Darai E, Nassar-Slaba J, Lafont C, Thomassin-Naggara I: Value of Magnetic Resonance Imaging for the Diagnosis of Ovarian Tumors: A Review. Journal of Computer Assisted Tomography 2008, 32: 712–723. 10.1097/RCT.0b013e31815881efPubMedCrossRef

22.

Kinkel K, Frei K, Balleyguier C, Chapron C: Diagnosis of endometriosis with imaging: a review. European Radiology 2006, 16: 285–298. 10.1007/s00330-005-2882-yPubMedCrossRef

23.

Tanaka YO, Okada S, Yagi T, et al.: MRI of Endometriotic Cysts in Association With Ovarian Carcinoma. American Journal of Roentgenology 2010, 194: 355–361. 10.2214/AJR.09.2985PubMedCrossRef

24.

Namimoto T, Awai K, Nakaura T, Yanaga Y, Hirai T, Yamashita Y: Role of diffusion-weighted imaging in the diagnosis of gynecological diseases. European Radiology 2009, 19: 745–760. 10.1007/s00330-008-1185-5PubMedCrossRef

25.

Thomassin-Naggara I, Toussaint I, Perrot N, et al.: Characterization of Complex Adnexal Masses: Value of Adding Perfusion- and Diffusion-weighted MR Imaging to Conventional MR Imaging. Radiology 2011, 258: 793–803. 10.1148/radiol.10100751PubMedCrossRef

26.

Sala E, Rockall A, Rangarajan D, Kubik-Huch RA: The role of dynamic contrast-enhanced and diffusion weighted magnetic resonance imaging in the female pelvis. European journal of radiology 2010, 76: 367–385. 10.1016/j.ejrad.2010.01.026PubMedCrossRef

27.

Punwani S: Diffusion weighted imaging of female pelvic cancers: Concepts and clinical applications. European journal of radiology 2011, 78: 21–29. 10.1016/j.ejrad.2010.07.028PubMedCrossRef

28.

Takeuchi M, Matsuzaki K, Nishitani H: Diffusion-Weighted Magnetic Resonance Imaging of Ovarian Tumors: Differentiation of Benign and Malignant Solid Components of Ovarian Masses. Journal of Computer Assisted Tomography 2010, 34: 173–176. 10.1097/RCT.0b013e3181c2f0a2PubMedCrossRef

29.

Katayama M, Masui T, Kobayashi S, et al.: Diffusion-Weighted Echo Planar Imaging of Ovarian Tumors: Is It Useful to Measure Apparent Diffusion Coefficients? Journal of Computer Assisted Tomography 2002, 26: 250–256. 10.1097/00004728-200203000-00015PubMedCrossRef

30.

Fujii S, Kakite S, Nishihara K, et al.: Diagnostic accuracy of diffusion-weighted imaging in differentiating benign from malignant ovarian lesions. Journal of Magnetic Resonance Imaging 2008, 28: 1149–1156. 10.1002/jmri.21575PubMedCrossRef

31.

Nakayama T, Yoshimitsu K, Irie H, et al.: Diffusion-weighted echo-planar MR imaging and ADC mapping in the differential diagnosis of ovarian cystic masses: Usefulness of detecting keratinoid substances in mature cystic teratomas. Journal of Magnetic Resonance Imaging 2005, 22: 271–278. 10.1002/jmri.20369PubMedCrossRef

32.

Moteki T, Ishizaka H: Evaluation of cystic ovarian lesions using apparent diffusion coefficient calculated from turboFLASH MR images. British Journal of Radiology 1998, 71: 612–620.PubMedCrossRef

33.

Moteki T, Horikoshi H, Endo K: Relationship between apparent diffusion coefficient and signal intensity in endometrial and other pelvic cysts. Magnetic resonance imaging 2002, 20: 463–470. 10.1016/S0730-725X(02)00524-6PubMedCrossRef

Title: Evaluation of primary adnexal masses by 3T MRI: categorization with conventional MR imaging and diffusion-weighted imaging
Authors: He Zhang
Guo-Fu Zhang
Zhi-Yan He
Zheng-Yu Li
Ming Zhu
Gui-Xiang Zhang
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Journal of Ovarian Research / Issue 1/2012
Electronic ISSN: 1757-2215
DOI: https://doi.org/10.1186/1757-2215-5-33

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of primary adnexal masses by 3T MRI: categorization with conventional MR imaging and diffusion-weighted imaging

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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