TITLE:
MRI is a state of art imaging modality in characterization of indeterminate adnexal masses
AUTHORS:
Amit Nandan Dhar Dwivedi, Shivi Jain, Ram Chandra Shukla, Madhu Jain, Arvind Srivastava, Ashish Verma
KEYWORDS:
MRI; Adnexal Masses; Diagnostic Accuracy
JOURNAL NAME:
Journal of Biomedical Science and Engineering,
Vol.6 No.3A,
March
29,
2013
ABSTRACT: Aims
and Objectives: The aim of this diagnostic observational study was to find an
association of final diagnosis of adnexal masses suggested by MRI and compare
it as an imaging modality in determining the origin, nature (benign/malignant)
& characteristics of adnexal masses by calculating sensitivity,
specificity, and diagnostic accuracy. Materials and Methods: The present study
was carried out in 90 patients in the department of radio diagnosis and imaging,
institute of medical sciences, Banaras Hindu
University (BHU). The patients were referred from department of obstetrics
& gynecology, institute of medical sciences. Majority of the referred cases
were those who had clinical features of abdominal pain, abdominal lump,
menstrual irregularity, ascites, and anorexia or weight loss & in whom
adnexal mass was suspected clinically. Magnetic resonance imaging was performed using 1.5 Tesla MR Scanner, Magnetom Avanto (Siemens Healthcare). Results: Out of 114 masses, 17
(14.9%) were malignant. The benign adnexal masses were maximum in the age group
20 - 39 years (56/97, 57.7%), while malignant masses were mainly found in women
≥60 years of age (11/17, 64.7%). CA-125 level was grossly elevated in
association with 35.3% of the malignant masses. On MRI, the sensitivity for the
mass of ovarian origin was (97.7%) and specificity was (73.1%). The diagnostic
accuracy was (92.1%). The mass of uterine
origin had a sensitivity of (73.1%) and diagnostic accuracy (99.1%).
Conclusion: MRI, because of its accuracy in identifying the origin of adnexal
mass and characterizing the solid, hemorrhagic, fatty and fibrous content,
may obviate surgery or significantly contribute to preoperative planning for a
sonographically indeterminate mass. MRI is the state of the art imaging modality
for evaluation of adnexal masses with an overall high diagnostic accuracy.