Critical evaluation of the specificity of MRI and TVUS for differentiation of malignant from benign adnexal lesions |
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Authors: | M Reuter J-C Steffens U Schüppler J Lüttges C Muhle G Brinkmann A Maschek D Weisner R-P Spielmann M Heller |
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Institution: | (1) Department of Diagnostic Radiology, University of Kiel, Arnold-Heller-Strasse 9, D-24 105 Kiel, Germany, DE;(2) Department of Gynecology and Obstetrics, University of Kiel, Arnold-Heller-Strasse 9, D-24 105 Kiel, Germany, DE;(3) Department of Pathology, University of Kiel, Arnold-Heller-Strasse 9, D-24 105 Kiel, Germany, DE;(4) Nycomed Imaging, Munich, Germany, DE |
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Abstract: | The aim of our work was to study the specificity of MRI in comparison with transvaginal US for differentiation of malignant
from benign adnexal lesions. A total of 67 patients with clinically suspicious adnexal lesions were evaluated by MRI. Transaxial
and coronal images were acquired using T1-weighted sequences before and following IV contrast and T2-weighted sequences. In
all patients transvaginal ultrasound examinations (TVUS) were performed. For both imaging modalities each lesion was classified
separately as either benign or malignant according to previously published criteria. Pathologic findings were available in
65 cases. Both MRI and TVUS correctly classified the 12 malignant lesions (sensitivity 100 %). Specificity (MRI: 78.2 %, TVUS:
65.5 %) and accuracy (MRI: 82 %, TVUS: 71.6 %) were higher with MRI than with TVUS, but differences were statistically not
significant (p = 0.18 and p = 0.20, chi-square test). There was agreement/disagreement between findings of MRI and US in 52/15 lesions. The macroscopic
criteria for malignancy are unspecific and result in a limitation of the specificity of both MRI and TVUS. The MRI technique
is a valuable adjunct to TVUS by enabling further clarification of adnexal tumors with equivocal complex or solid vaginal
sonographic findings.
Received 6 December 1996; Revision received 17 March 1997; Accepted 9 April 1997 |
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Keywords: | : Ovary Neoplasms Pelvis MR US |
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