Keywords:
Genital / Reproductive system female, Genital / Reproductive system male, Pelvis
Authors:
S. Serter, G. S. Yilmaz, G. Pekindil, T. Guvenal, A. R. Kandiloglu; Manisa/TR
DOI:
10.1594/ecr2010/C-3300
Results
20 patients were diagnosed as hitopathologically.The histopathologic diagnoses were: Serous and hemorrhagic cysts-endometrioma (8 patient), myoma (7 patient) ,adenoyosis (6 patient: 5 focal,1 diffuse), enflamatuar pathologies (1 patient :tuboovarian abscess),teratoma(3 patient),endometrium ca (4 patient),ovarian ca (7 patient),cervix ca (3 patient).Some of these pathologies were together .
We diagnosed 25 patients with typical radiologic appearence and clinically follow up as a certain diagnose.These patients were: Myoma (14 patient),hemorrhagic cyst-endometrioma (9 patient),follicule and retention cyst (4 patient),teratoma (3 patient). Seventeen more patients were either lost to follow-up or did not undergo surgery at our institution and so had no corresponding pathologic data available.Because of this reason these patients were out of study.
The pattern of contrast enhancement in dynamic LAVA sequence and digital subtraction series as straight-linear and late (LAVA third-forth phase) types were characterized as benign in 31 patients and heterogenous-nodular and early (LAVA first-sekond phase)types as malign in 14 patients. The sensitivity value of the differentiation of benign /malign lesions with LAVA sequence was estimated as % 95 and also the other values specifity %100,positive predictive value %100 and negative predictive value %92 by the statistical evaluation.We diagnosed patients with cervix and endometrium cancer by MRI without staging.Digital substruction technique was a role of facilitator factor in benign lesions with hemorragic component especially high signal in T1W images.(Figure 1) On the other hand it was a problem solving methode of simultaneous adnexal mass with subserous myoma by typical contrast enhancement pattern of myoma and digital subtraction technique of ovarian masses with benign contrast enhancement. (Figure 2)
We considered 2 patients as malign with typical contrast enhancement but they were diagnosed as benign pathology by histopathological evaluation.In one of these patients we misapprehended because of peripheric nodular contrast enhancement .It was diagnosed histopatologically as serous cystadenoma – techoma. (Figure 3) The other patient we were mistaken was endometriosis focus within hemorragic cyst which was interpreted as enhancing papillary projections. Patients who were reported as benign were never mistaken by histopathological diagnose or follow up.