ROLE OF MRI MODALITIES IN ASSESSMENT OF CYSTIC LESIONS OF THE FEMALE PELVIS

Abstract

• Determining whether a clinically diagnosed adnexal mass is benign or malignant is frequently not possible until surgical exploration and histologic examination are performed. Consequently, it may not be possible to decide preoperatively whether conservative or radical surgery is appropriate. A reliable method with which to differentiate a benign from a malignant adnexal mass would provide a basis for optimal preoperative planning. • Transvaginal ultrasound is the diagnostic method of choice as a screening technique for ovarian processes. Suspicious findings on transvaginal ultrasound should be confirmed on MR imaging. If MR imaging confirms a dermoid or endometrial cyst, further diagnostic procedures may be unnecessary. In all other cases, a surgical evaluation must be considered. • Our study was conducted on twenty (21) complex adnexal lesions, conventional MRI suggested malignant pathology in three masses; all proved to be malignant. MRI also suggested borderline pathology in four masses, two of them were truly borderline tumors, while one of them was proven to be benign and the last was histopathologically proven malignant. Conventional MRI also suggested benign pathology in fourteen lesions; all of them were true benign. MRI had shown 93.3% sensitivity, 100% specificity, 95.2% accuracy, 100% positive predictive value and 85.7% negative predictive value in its individual performance during the assessment of the included adnexal masses.