Assess the Role of Sonography and MRI in Diagnosing Ovarian Masses
Role of Sonography and MRI in Diagnosing Ovarian Masses
Background: In order to conduct appropriate surgical treatments, the characterization of ovarian lesions is of considerable significance and can affect patient care. A multidisciplinary approach based on physical assessment, laboratory tests and imaging techniques includes adequate measurement of the adnexal masses. The aim is to assess the role of Sonography and MR in diagnosing ovarian masses, to study imaging characteristics of ovarian masses on USG and Doppler in correlating these findings with MR features. Subjects and Methods: The present study was carried out in the department of radiodiagnosis to determine the efficacy of sonography and MRI in the diagnosis of ovarian masses. The study group comprised 50 patients with clinically suspected ovarian masses and imaging was carried out on all patients with ovarian masses and imaging was carried out on all patients with ovarian masses. All the masses were evaluated on sonography based on the Sassone scoring system. Morphological analysis was performed for each mass based on wall thickness, inner wall structure, septal structure and echogenicity of mass. The color flow was carried out, subsequently; MRI was carried out for each patient. Radiological diagnosis was confirmed after surgery on histopathological examination. Results: The majority of the patients were in the age group of 31-40 years. The most common symptoms noted were pain in the abdomen. The most common clinical finding was a palpable mass. The application of Sassone sonomorphologic score >9 was identified in 8 masses, out of which 7 were malignant and 1 was a benign lesion. The colour flow was detected in 38 out of 50 masses. The presence of flow, type of flow, vessel arrangement, morphology and location were noted and on pulsed Doppler the RI and PI values were calculated. Out of 8 malignant cases, 5 were diagnosed as malignant according to the Caruso score. The overall sensitivity 100 %, specificity is 97.6% and diagnostic accuracy is 98% of MRI which is higher than that of ultrasound and CDS. Conclusion: We conclude that MRI is a superior diagnostic modality in establishing the diagnosis of ovarian masses.
Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1998. CA Cancer J Clin. 1998;48(1):6–29. Available from: https://dx.doi.org/10.3322/canjclin.48.1.6.
Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin. 1997;52(1):23–47. Available from: https://doi.org/10.3322/canjclin.52.1.23.
Sharma M, Khangar B, Mallya V, Khurana N, Gupta S. Coexisting Brenner Tumor and Endometrial Carcinoma. J Midlife Health. 2017;8(2):89–91. Available from: https://dx.doi.org/10.4103/jmh.JMH_3_17.
Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obste Gynecol. 1991;78(1):70–76.
Caruso A, Caforio L, Testa AC, Ciampelli M, Panici PB, Mancuso S. Transvaginal Color Doppler Ultrasonography in the Presurgical Characterization of Adnexal Masses. Gynecol Oncol. 1996;63(2):184–191. Available from: https://dx.doi.org/10.1006/gyno.1996.0304.
Patel MD, Feldstein VA, Chen DC, Lipson SD, Filly RA. Endometriomas: Diagnostic Performance of US. Radiology. 1999;210(3):739–745. Available from: https://dx.doi.org/10.1148/radiology.210.3.r99fe61739.
Stevens SK, Hricak H, Stern JL. Ovarian lesions: detection and characterization with gadolinium-enhanced MR imaging at 1.5 T. Radiology. 1991;181(2):481–488. Available from: https://dx.doi.org/10.1148/radiology.181.2.1924792.
Bennett GL, Slywotzky CM, Giovanniello G. Gynecologic Causes of Acute Pelvic Pain: Spectrum of CT Findings. Radiographics. 2002;22(4):785–801. Available from: https://dx.doi.org/10.1148/radiographics.22.4.g02jl18785.
Bazot M, Nassar-Slaba J, Thomassin-Naggara I, Cortez A, Uzan S, Daraï E. MRI compared with intra operative frozen- section examination for the diagnosis of adnexal tumors; co- relation with final histology. Eur Radiol. 2006;16(12):2687– 2699. Available from: https://doi.org/10.1007/s00330-006-0163-z.
Kier R, Smith RC, McCarthy SM. Value of lipid- and water-suppression MR images in distinguishing between blood and lipid within ovarian masses. Am J Roentgenol. 1992;158(2):321–325. Available from: https://dx.doi.org/10.2214/ajr.158.2.1729791.
Outwater EK, Mitchell DG. Normal ovaries and functional cysts: MR appearance. Radiology . 1996;198(2):397–
Available from: https://doi.org/10.1148/radiology.198.2.8596839.
Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MRI of ovarian masses with emphasis on differential diagnosis. Radiographics. 2002;22(6):1305–1325. Available from: https://doi.org/10.1148/rg.226025033.
Kim JS, Woo SK, Suh SJ. Ultrasonographic diagnosis of tube masses, emphasis on detection of the ovary. J Korean Soc Med US. 1990;9:136–144.
Kurman RJ. Springer-Verlag; 1994.
Graif M, Shalev J, Strauss S, Engelberg S, Mashiach S, Itzchak Y. Torsion of the ovary: sonographic features. Am J Roentgenol. 1984;143(6):1331–1334. Available from: https://dx.doi.org/10.2214/ajr.143.6.1331.
Vijayaraghavan SB. Sonographic Whirlpool Sign in Ovarian Torsion. J Ultrasound Med. 2004;23(12):1643–1649. Available from: https://doi.org/10.7863/jum.2004.23.12.1643.
Sheth S, Fishman EK, Buck JL, Hamper UM, Sanders RC. The variable sonographic appearances of ovarian teratomas: correlation with CT. Am J Roentgenol. 1985;151:331–335. Available from: https://doi.org/10.2214/ajr.151.2.331.
Togashi K, Nishimura K, Kimura I, Tsuda Y, Yamashita K, Shibata T, et al. Endometrial cysts: diagnosis with MR imaging. Radiology. 1991;180(1):73–78. Available from: https://dx.doi.org/10.1148/radiology.180.1.2052726.
Schneider VL, Schneider A, Reed KL, Hatch KD. Comparison of Doppler with two-dimensional sonography and CA 125 for prediction of malignancy of pelvic masses. Obstet Gynecol. 1993;81:983–988.
Kurjak A, Predanic M, Kupesic-Urek S, Jukic S. Transvaginal Color and Pulsed Doppler Assessment of Adnexal Tumor Vascularity. Gynecol Oncol. 1993;50(1):3–9. Available from: https://dx.doi.org/10.1006/gyno.1993.1154.
Rockall AG, Meroni R, Sohaib SA, Reynolds K, Alexander- Sefre F, Shepherd JH, et al. Evaluation of endometrial carcinoma on magnetic resonance imaging. Int J Gynecol Cancer . 2007;17(1):188–196. Available from: https://dx.doi.org/10.1111/j.1525-1438.2007.00805.x.
Hricak H, Chen M, Coakley FV, Kinkel K, Yu KK, Sica G, et al. Complex Adnexal Masses: Detection and Characterization with MR Imaging—Multivariate Analysis. Radiol- ogy. 2000;214(1):39–46. Available from: https://dx.doi.org/10.1148/radiology.214.1.r00ja3939.
Huber S, Wagner M, Zuna I, Medl M, Czembirek H, Delorme S. Locally advanced breast carcinoma: evaluation of mammography in the prediction of residual disease after induction chemotherapy. Anticancer Res. 2000;20(1B):553– 558.
Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S, et al. Deep Pelvic Endometriosis: MR Imaging for Diagnosis and Prediction of Extension of Disease. Radiology. 2004;232(2):379–389. Available from: https://dx.doi.org/10.1148/radiol.2322030762.
Booth SJ, Pickles MD, Turnbull LW. In vivo magnetic resonance spectroscopy of gynaecological tumours at 3.0 Tesla. BJOG. 2009;116(2):300–303. Available from: https://doi.org/10.1111/j.1471-0528.2008.02007.x.
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