Volume 7, Issue 3, September 2019, Page: 66-80
The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses
Al-Shimaa Magdy Ammar, Radiology Department, Tanta University, Tanta, Egypt
Mohammed Mahmoud Dawoud, Radiology Department, Tanta University, Tanta, Egypt
Mohamed Mohamed Hefeda, Radiology Department, Tanta University, Tanta, Egypt
Manal Ezzat Badawy, Radiology Department, Tanta University, Tanta, Egypt
Essmat Hamdy Abozaid, Department of Obstetric and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt
Received: Jul. 12, 2019;       Accepted: Aug. 15, 2019;       Published: Sep. 30, 2019
DOI: 10.11648/j.ijmi.20190703.12      View  22      Downloads  9
Abstract
The aim of the present study was to evaluate the role of diffusion weighted imaging (DWI) and dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the differentiation between benign and malignant endometrial, uterine and cervical masses. The study included 78 patients. All patients had uterine or cervical masses on ultrasound examination. All patients had conventional MRI, DWI, and DCE-MRI. The patients were classified into three groups: patients with endometrial masses, myometrial lesions and cervical masses. The mean ADC value of benign endometrial and myometrial lesions was higher significantly from malignant lesions (P value <0.001 and <0.001). The cut off value of ≤1.1×10-3mm2/sec as a predictor of malignant lesions yielded a sensitivity, specificity, PPV, NPV and accuracy of 89.65%, 91.54%, 88.67%, 92.41% and 95.21% respectively. The semi-quanitative parameters of DCE-MRI including the enhancement amplitude (EA), maximum slope (MS) and time of half rising (THR), all showed significant difference between the benign and malignant lesion in endometrial, myometrial and cervical lesions. In clinically and sonographically indeterminate endometrial, myometrial or cervical masses, DWI and DCE-MRI proved to be more accurate than conventional MRI in differentiation between benign and malignant masses, with the DWI and ADC value had more sensitivity and specificity especially in endometrial masses and should be included in the routine pelvic MRI. DCE-MRI should be reserved for still questionable cases after DWI and to study the vascularity of the lesions.
Keywords
Uterine Masses, Endometrial Masses, DWI, Dynamic Contrast MRI, Functional MRI
To cite this article
Al-Shimaa Magdy Ammar, Mohammed Mahmoud Dawoud, Mohamed Mohamed Hefeda, Manal Ezzat Badawy, Essmat Hamdy Abozaid, The Utility of Diffusion Weighted Imaging and Dynamic Contrast Enhanced MRI Techniques in Differentiation Between Benign and Malignant Uterine Masses, International Journal of Medical Imaging. Vol. 7, No. 3, 2019, pp. 66-80. doi: 10.11648/j.ijmi.20190703.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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