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Magnetic resonance evaluation of adnexal masses
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Orientador(es)
Resumo(s)
Background: Accurate evaluation of adnexal masses allows correct surgical procedure,
avoiding unnecessary surgery.
Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis
of malignancy of adnexal lesions.
Material and Methods: We retrospectively reviewed the pelvic MRI scans of 161 patients
with 199 surgically confirmed adnexal masses, between November 1998 and June 2005.
The criteria for adnexal malignancy were contrast-enhanced solid lesions, contrastenhanced
solid components in mixed lesions (except those with low-signal-intensity solid
components on T2-weighted imaging [T2WI]), contrast-enhanced papillary projections
in cystic lesions (except those with low-signal-intensity papillary projections on T2WI),
or septal thickness ]3 mm. Ascites, peritoneal metastasis, and pelvic adenopathy were
also regarded as criteria for malignancy.
Results: On MRI evaluation, 97 adnexal lesions were malignant and 102 were nonmalignant.
Thirty-two percent of patients with ascites had benign lesions. Histopathologic
evaluation of the adnexal lesions showed that 83 were malignant (true positives),
100 were non-malignant (true negatives), and seven were uncertain malignant potential
tumors; two were false negative and seven were false positive. The MRI sensitivity and
specificity for malignancy were 98% and 93%, respectively. MRI reached an accuracy of
95%, with a positive predictive value of 0.92 and a negative predictive value of 0.98 for
malignant adnexal lesions. The kappa coefficient was 0.906, indicating almost perfect
agreement between MRI and histological results.
Conclusion: MRI is an accurate method for evaluating the malignancy of adnexal lesions.
Descrição
Palavras-chave
Adnexal masses Genital Magnetic resonance imaging Ovarian tumor Pelvis
Contexto Educativo
Citação
Guerra, A.; Cunha, T.M.; Félix, A.Magnetic Resonance Evaluation of Adnexal Masses, Acta Radiologica, 49, 6, 700-709, 2008.