The Usefulness of Diffusion Weighted and Contrast Enhanced Magnetic Resonance Imaging in Characterization of Inconclusive Ovarian Mass

Abstract

Introduction: Ovarian cancer is the commonest reason for death in females due to gynecologic malignancy around the world. In contrast to other gynecologic tumours, the definitive diagnosis is accomplished days after of the index surgery by the histopathology. Preoperative assessment based on conventional MRI is not accurate. Information is expanding increasing about the ability of new MRI modalities to assess ovarian mass. Aim of the study: To assess the ability of dynamic contrast-enhanced MRI (DCE–MRI), and Diffusion-weighted image (DWI) to describe uncertain ovarian masses. Patients and Methods: This is a retrospective study. Patients were referred from radio-diagnosis department and gynecology department of Qena faculty of medicine hospitals, South Valley University. Patients had uncertain adnexal masses at ultrasound. Magnetic resonance examination was doneutilizing 1.5 Tesla machine. The protocol included T1WI, T2WI, T1WI following contrast, and DWI. Results: We included 44 patients with different forms of complex cystic and solid ovarian masses. The final pathology of the ovarian masses was 18 benign, 4 borderline, and 22 malignant. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for DWI were 100%, 94.4%, 96.3%, 100%, and 97.7% respectively. The performance of DWI was higher than the conventional MRI and DCE-MRI. Conclusion: DCE-MRI and DWI have accepted ability to recognize malignant ovarian mass.