Dynamic Contrast-Enhanced and Diffusion Weighted Magnetic Resonance Imaging; Useful Tools for Characterization of Ovarian Masses

Document Type : Original Article

Authors

1 Radiodiagnosis, Faculty of Medicine, Benha University.

2 Gyneacology & Obstatrics Department-Faculty of Medicine-Benha University

3 Radiodiagnosis, Faculty of Medicine, Banha University

Abstract

Abstract
Background: Determining whether a clinically diagnosed adnexal mass is benign or malignant is frequently not possible until surgical exploration and histologic examination are performed. This study aimed at evaluating the role of diffusion-weighted MRI and dynamic contrast enhanced MR in characterization of ovarian masses. Methods: This prospective study included 40 patients, conducted in radiology department in Benha university hospital . During the period from December 2020 to March 2022. Before starting the research both informed participant consent and Benha University ethical committee approval were taken .Results: the addition of the DWI improved the sensitivity, PPV, NPV and accuracy of the conventional MRI from 74%, 76%, 44% and 66% to 89%, 78%, 64% and 75% respectively, yet the specificity was decreased from 47 % to 41 %; We had 12 borderline ovarian tumors which showed variable appearance on DWI. About ten cases showed facilitated diffusion of its solid component with a high ADC value (1.4 x10-3mm2/S) suggesting benign pathology (false negative). Two cases showed restricted diffusion with high signal on DWIs and mean ADC value of 0.8 x10-3mm2/S; 7 lesions out of 17 (41.2%) showed steady rise with no definite peak (type 1 curve) while the other ten lesions (58.8 %) showed rapid rise with a plateau, while some of the invasive malignant lesions 18 (66.6 %) showed initial rapid steep early enhancement. Conclusion: DCE and DWIs sequences are good supportive techniques to conventional MRI in the categorization of ovarian masses into benign, borderline and invasive malignant tumors.

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