Interpretation of conventional magnetic resonance imaging with diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient map in characterization of uterine adnexal lesions

Abstract

Background Diffusion-weighted imaging (DWI) is one of the promising new functional imaging techniques that have shown to be effective in the differentiation of benign from malignant adnexal masses. Patients and methods This prospective study was conducted on 21 female patients with 25 adnexal masses based on pelvi-abdominal or trans-vaginal ultrasound study. The study was conducted during the period from September 2019 to March 2020 at the Radiology Department and approved by the ethics committee, and all patients gave their informed consent before inclusion in the study. Pelvic MRI with DWI was performed for all cases. The radiological and histopathological results were collected and then analyzed using a specialized computer statistical program. Results Among the 25 ovarian masses included in our study, 80% (20/25) were benign and 20% (5/25) were malignant according to histopathological results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI have been increased from 80, 75, 44, 94, and 76%, respectively, for conventional MRI to 100, 90, 71, 100, and 92%, respectively, for DWI. Conclusion Combination of DWI and conventional MRI provides an effective noninvasive technique for assessment of the adnexal masses. It improves the sensitivity and specificity of MRI and thus increasing radiologist's confidence in image interpretation which will finally reflect on patient's outcome and prognosis.