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Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses

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Abstract

The purpose of this study was to prospectively assess the contribution of diffusion-weighted MR imaging (DWI) for characterizing complex adnexal masses. Seventy-seven women (22–87 years old) with complex adnexal masses (30 benign and 47 malignant) underwent MR imaging including DWI before surgery. Conventional morphological MR imaging criteria were recorded in addition to b 1,000 signal intensity and apparent diffusion coefficient (ADC) measurements of cystic and solid components. Positive likelihood ratios (PLR) were calculated for predicting benignity and malignancy. The most significant criteria for predicting benignity were low b 1,000 signal intensity within the solid component (PLR = 10.9), low T2 signal intensity within the solid component (PLR = 5.7), absence of solid portion (PLR = 3.1), absence of ascites or peritoneal implants (PLR = 2.3) and absence of papillary projections (PLR = 2.3). ADC measurements did not contribute to differentiating benign from malignant adnexal masses. All masses that displayed simultaneously low signal intensity within the solid component on T2-weighted and on b 1,000 diffusion-weighted images were benign. Alternatively, the presence of a solid component with intermediate T2 signal and high b 1,000 signal intensity was associated with a PLR of 4.5 for a malignant adnexal tumour. DWI signal intensity is an accurate tool for predicting benignity of complex adnexal masses.

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Authors and Affiliations

  1. Department of Radiology, Hôpital Tenon, Assistance Publique Hopitaux de Pariss, 4 rue de la Chine, 75020, Paris, France

    Isabelle Thomassin-Naggara, Irwin Toussaint, Claude Marsault & Marc Bazot

  2. Department of Gynecology-Obstetrics, Hôpital Tenon, Assistance Publique Hopitaux de Pariss, 4 rue de la Chine, 75020, Paris, France

    Emile Daraï

  3. LRI-EA4062, Université Rene Descartes, Paris, France

    Isabelle Thomassin-Naggara, Charles A. Cuenod & Laure Fournier

  4. Department of Radiology, Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hopitaux de Paris, Paris, France

    Laure Fournier

  5. Department of Radiology, Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hopitaux de Paris, 20 rue Leblanc, 75015, Paris, France

    Charles A. Cuenod

Authors
  1. Isabelle Thomassin-Naggara
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  2. Emile Daraï
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  3. Charles A. Cuenod
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  4. Laure Fournier
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  5. Irwin Toussaint
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  6. Claude Marsault
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  7. Marc Bazot
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Correspondence to Charles A. Cuenod.

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Thomassin-Naggara, I., Daraï, E., Cuenod, C.A. et al. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses. Eur Radiol 19, 1544–1552 (2009). https://doi.org/10.1007/s00330-009-1299-4

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  • DOI: https://doi.org/10.1007/s00330-009-1299-4

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