Role of Magnetic Resonance Imaging in evaluation of Ovarian Tumors

Abstract

Ovarian carcinoma is an insidious disease, and patients often present with an advanced (extra pelvic) stage of disease. Despite clinical advance and improved surgical techniques, it remains the deadliest form of gynecologic malignancy. The primary goal of imaging in the evaluation of an adnexal mass is to differentiate malignant and benign diagnoses in order to direct patients to the appropriate treatment algorithm. Magnetic resonance (MR) imaging has proved useful for characterizing benign and malignant ovarian tumors; moreover, it enables a specific diagnosis to be made for certain pathologic types. For example, MR imaging is well to provide information about hemorrhage, fat, and collagen. Gadolinium-enhanced MR imaging serves as a problem-solving modality in cases of indeterminate adnexal masses. A combination of T1-weighted images and T1-weighted images with fat saturation helps to differentiate most common benign adnexal masses from malignant ones.

Functional imaging is becoming increasingly important in the evaluationof cancer patients because of the limitations of morphologic imaging. Evaluation of the signal intensity on the DWI sequence should always be correlated to the imaging features on conventional sequences and the possibility of T2 shine through or hemorrhage as a cause of hyperintensity on b=1000 diffusion images should always be considered. Magnetic resonance spectroscopy is a non-invasive means of obtaining metabolic information by recording signals from metabolites present in tissues, while the water signal is suppressed. MRS plays an important role in the detection of ovarian tumors by differentiating between them whether being benign or malignant. Dissemination of tumor to lymph nodes is one of the principal routes of metastatic disease. The presence or absence of nodal disease is an important prognostic factor in gynecologic malignancies. Current imaging techniques such as computed tomography and magnetic resonance (MR) imaging have limitations because they rely almost exclusively on size criteria. MR lymphography uses a lymph node–specific contrast agent (ferumoxtran-10), Allows differentiation from malignant nodes on the basis of alterations in signal intensity.