Aims and objectives
Ovarian cancer is currently one of the most common forms of the cancer in gynecology - for about 3.6 % of all cases,
with the mortality for about 4,3 %.
In Europe it is the leading cause of death among gynecologic malignancies,
ranking fifth in incidence (exceeded only by breast,
colorectum,
lung and corpus uteri) and sixth in mortality (exceeded by breast,
colorectum,
lung,
pancreas and stomach).
An important reason for high mortality rates of ovarian cancer is the identification at late stages.
The diagnosis...
Methods and materials
A total of 52 patients (22-87 years,
mean – 58 years; 19 patients with benign/borderline OT (BOT),
including endometriomas and cystic teratomas and 33 cases with malignant OT (MOT) were examined by MRI (Magnetom Espree®1.5T and Magnetom Skyra®3.0T (Siemens,
Germany) before surgery and/or combined treatment.
For all of the patients were performed,
routine spin-echo T1WI and T2WI,
DWI (b value = 50,
1000,
1500,
2100,
2500) with ADC maps and DCE-MRI after gadobutrol (Gadovist®,
Bayer,
Germany) i.v.
injection (3 ml/s) at standard dose 0.1 mmol/kg...
Results
Teratomas had heterogeneous signal at all type of MRI images andheterogeneous type of contrast enhancement (p=0,06).
Signal intensity inversion on T2WI (mean and low signal) and T1WI (high signal) for endometriomas was found in all cases.
MOT and mature cystic teratomas and endometriomas showed high signal intensity on DWI (p=0,007) with low ADC values (Fig 1,2,3).
Fibromas and other BOT showed low signal intensity on DWI with ADC values (p<0,001) (Fig 4,5).
But there was not significant difference on DWI and on ADC maps between...
Conclusion
Complex of DCE-MRI,
T1WI and T2WI is enough for precise MRI diagnosis in patients with OT exclude teratomes without fat component.
No statistically significant difference in ADC values between BOT and MOT was revealed.
Although a standard deviation of the signal intensity on DWI and ADC map looks promising for BOT and MOT differentiation diagnostics.
DCE-MRI is an important MRI modality for BOT and MOT differentiation.
Personal information
Olimov B.P.
resident of radiology department Blokhin Russian Cancer Research Center
e-mail:
[email protected]
References
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Spencer...
