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Year : 2019  |  Volume : 32  |  Issue : 3  |  Page : 881-888

The role of diffusion-weighted MRI on the differentiation of complex adnexal masses

1 Department of Diagnostic Radiology, Faculty of Medicine, Menoufia University Hospital, Shebin El-Kom, Menoufia Governorate, Egypt
2 Department of Diagnostic Radiology, Bolaq El-Dakror Hospital, Bolaq El-Dakror, Giza Governorate, Egypt

Correspondence Address:
Hamed G Ali
Shebin El-Kom 32511, Menoufia Governorate
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_100_18

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Background Conventional MRI has an established role in gynecologic imaging. However, increasing clinical demand for improved lesion characterization and disease mapping to optimize patient management has resulted in the incorporation of newer sequences, such as diffusion-weighted imaging (DWI), into routine protocols for pelvic MRI. DWI provides functional information on the microenvironment of water in tissues, hence augmenting the morphologic information derived from conventional MRIs. Objective The objective of this study was to highlight the role of DWI in differentiating benign from malignant complex adnexal masses. Patients and methods Twenty-five patients with adnexal masses underwent conventional MRI and DWI and the cases were proven by postsurgery pathological examination. Analysis of the pathological specimen with lesion morphology, signal characteristics, and correlation with the appearance at DWI followed by apparent diffusion coefficient values measurement were obtained. Results Twenty-five patients with adnexal mass lesions were included. Included masses proved benign in 18 (72%) and malignant in seven (28%). Restricted diffusion was observed in proved malignant masses (24%, n = 6/25). Benign tumors with high DWI signal intensity evidence at 24% also. The mean apparent diffusion coefficient value was 1.4+0.34×10−3 and 1.02+0.06×10−3 mm2/s, for benign and malignant masses, respectively. Conclusion DWI supported by conventional MRI data can confirm or exclude malignancy in suspicious ovarian masses. A combined analysis of quantitative and qualitative criteria and a knowledge of the sequence pitfalls are required.

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