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The role of diffusion-weighted imaging in the evaluation of adnexal lesions

PURPOSE: Magnetic resonance imaging (MRI) has been used as a problem-solving tool in the diagnosis of adnexal lesions. Both benign and malignant ovarian masses can present as complex adnexal lesions. Preoperative diagnosis of malignancy is essential for planning the surgical approach and appropriate...

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Autores principales: Srirambhatla, Annapurna, Hosamani, Roopa Devi, Nandury, Eshwar Chandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453242/
https://www.ncbi.nlm.nih.gov/pubmed/36091651
http://dx.doi.org/10.5114/pjr.2022.119064
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author Srirambhatla, Annapurna
Hosamani, Roopa Devi
Nandury, Eshwar Chandra
author_facet Srirambhatla, Annapurna
Hosamani, Roopa Devi
Nandury, Eshwar Chandra
author_sort Srirambhatla, Annapurna
collection PubMed
description PURPOSE: Magnetic resonance imaging (MRI) has been used as a problem-solving tool in the diagnosis of adnexal lesions. Both benign and malignant ovarian masses can present as complex adnexal lesions. Preoperative diagnosis of malignancy is essential for planning the surgical approach and appropriate treatment regimen. The aim of our study was to determine the role of diffusion-weighted MRI (DWI) in differentiating benign from malignant adnexal lesions. MATERIAL AND METHODS: Fifty-five patients (constituting 67 lesions) referred to MRI for evaluation of adnexal lesions were studied using 1.5 T MRI. The signal on DWI (qualitative) and ADC values (quantitative DWI) of the solid and cystic components of the lesions were analysed separately. Chi-square test, cross tabulation, and ROC curves were used to determine features on DWI that could distinguish benign from malignant lesions. RESULTS: Of the 67 lesions, 50 were benign and 17 were malignant. There was a significant association of hyperintense signal of solid components on T2W and DWI with malignancy, with a p-value of 0.003 and 0.001, respectively. Benign lesions showed hypointense signal on T2W and DWI. ADC values of the solid components could not distinguish benign from malignant lesions; p = 0.290. The signal intensity and ADC values of the cystic fluid in benign and malignant lesions showed a significant overlap. CONCLUSIONS: Qualitative DWI acts as an adjunct to conventional MRI in differentiating benign from malignant adnexal lesions showing solid/mixed morphology. It plays no role in distinguishing lesions based on their cystic components. ADC values play no role in differentiating benign from malignant adnexal lesions irrespective of lesion morphology.
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spelling pubmed-94532422022-09-10 The role of diffusion-weighted imaging in the evaluation of adnexal lesions Srirambhatla, Annapurna Hosamani, Roopa Devi Nandury, Eshwar Chandra Pol J Radiol Original Paper PURPOSE: Magnetic resonance imaging (MRI) has been used as a problem-solving tool in the diagnosis of adnexal lesions. Both benign and malignant ovarian masses can present as complex adnexal lesions. Preoperative diagnosis of malignancy is essential for planning the surgical approach and appropriate treatment regimen. The aim of our study was to determine the role of diffusion-weighted MRI (DWI) in differentiating benign from malignant adnexal lesions. MATERIAL AND METHODS: Fifty-five patients (constituting 67 lesions) referred to MRI for evaluation of adnexal lesions were studied using 1.5 T MRI. The signal on DWI (qualitative) and ADC values (quantitative DWI) of the solid and cystic components of the lesions were analysed separately. Chi-square test, cross tabulation, and ROC curves were used to determine features on DWI that could distinguish benign from malignant lesions. RESULTS: Of the 67 lesions, 50 were benign and 17 were malignant. There was a significant association of hyperintense signal of solid components on T2W and DWI with malignancy, with a p-value of 0.003 and 0.001, respectively. Benign lesions showed hypointense signal on T2W and DWI. ADC values of the solid components could not distinguish benign from malignant lesions; p = 0.290. The signal intensity and ADC values of the cystic fluid in benign and malignant lesions showed a significant overlap. CONCLUSIONS: Qualitative DWI acts as an adjunct to conventional MRI in differentiating benign from malignant adnexal lesions showing solid/mixed morphology. It plays no role in distinguishing lesions based on their cystic components. ADC values play no role in differentiating benign from malignant adnexal lesions irrespective of lesion morphology. Termedia Publishing House 2022-08-20 /pmc/articles/PMC9453242/ /pubmed/36091651 http://dx.doi.org/10.5114/pjr.2022.119064 Text en © Pol J Radiol 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0). License (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Paper
Srirambhatla, Annapurna
Hosamani, Roopa Devi
Nandury, Eshwar Chandra
The role of diffusion-weighted imaging in the evaluation of adnexal lesions
title The role of diffusion-weighted imaging in the evaluation of adnexal lesions
title_full The role of diffusion-weighted imaging in the evaluation of adnexal lesions
title_fullStr The role of diffusion-weighted imaging in the evaluation of adnexal lesions
title_full_unstemmed The role of diffusion-weighted imaging in the evaluation of adnexal lesions
title_short The role of diffusion-weighted imaging in the evaluation of adnexal lesions
title_sort role of diffusion-weighted imaging in the evaluation of adnexal lesions
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453242/
https://www.ncbi.nlm.nih.gov/pubmed/36091651
http://dx.doi.org/10.5114/pjr.2022.119064
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