The validity of ultrasonography (US) and magnetic resonance imaging (MRI) in characterizing adnexal masses( prospective study )

Abstract

To determine whether ultrasonography and MRI images on the basis of their morphologic features and enhancement patterns. could help accurately distinguish benign adnexal masses from
malignant . Between January 2009and December 2011, prospectively studied 80 women (mean age 30 years, range 17 to 70 years) with clinically suspected adnexal masses. A single experienced sonographer performed transabdominal and transvaginal greyscale spectral and colour Doppler examinations. MRI was carried out on a 1.5T system using T1, T2 and fat-suppressed T1-weighted sequences before and after intravenous injection of gadolinium. The adnexal lesions were examined for several features including size, shape, character (solid–cystic), signal intensity, and enhancement Secondary signs such as ascites, peritoneal disease, and lymphadenopathy were noted. We compared the imaging features with the surgical and pathologic findings. All MR imaging features were categorized as benign or malignant without knowledge of clinical details, according to the imaging features which were compared with the surgical and pathological findings. . Sixty four (80%) cases of benign and 16(20%) cases of malignant on histopathology .Mean age (30 year ),size of mass range from 1-14 cm .Both MRI and US correctly diagnosed 11 cases with malignant and false negative diagnosis 1 case with malignant lesion , MRI correctly diagnosed 4 cases with malignant lesions, which on US were thought to be benign ., both MRI and US correctly diagnosed 45 cases with benign lesions . MRI correctly diagnosed 18cases with benign lesion(s), which on US were thought to be malignant. For characterizing lesions as malignant, the sensitivity of MRI were 93.75 %, and of US were 68.75 % , the US features were suggestive of malignancy (large masses and solid-cystic lesions with nodules). MRI is more sensitive than US for differentiation benign and malignant adnexal masses.