Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Bianka Chilla & Nik Hauser & Gad Singer & Mafalda Trippel & Johannes M. Froehlich & Rahel A. Kubik-Huch
- چاپ و سال / کشور: 2010
Description
Objective To determine the impact of MRI including DWI on therapeutic decision-making and costs in the work-up of patients with a indeterminate adnexal mass on ultrasound. Methods Thirty-eight patients with indeterminate ovarian lesions scheduled for surgery were included in this prospective study. In a questionnaire, the surgeon characterised the lesions based on a morphological score and determined the surgical procedure. The assessmentwas re-evaluated knowing MR findings and correlated with the final diagnosis. A costbenefit analysis of MRI was performed. The impact of including DWI in the MR protocol was assessed. Results MRI provided major diagnostic information in 11/38 cases (28.9%) resulting in abstention from surgery in 5 cases; moderate additional information was recorded in 10/38 (26.3%) patients. Overall a net cost saving (3’676 EUR) was achieved. DWI did not show a significant difference between benign and malignant lesions. Teratomas yielded significantly lower mean ADC values (0.597×10-3 mm2/s) compared with all other adnexal lesions (1.812×10-3 mm2/s); the mean ADC values in endometrioma (1.387×10-3 mm2/s) were significantly lower than in other cystic lesions (2.372×10-3 mm2/s). Conclusion Inclusion of MRI in the diagnostic algorithm of the indeterminate adnexal mass allows better differentiation of ovarian lesions resulting in a change of therapeutic decision-making with net cost savings.
Eur Radiol (2011) 21:1301–1310 DOI 10.1007/s00330-010-2018-x Received: 30 August 2010 / Revised: 20 October 2010 / Accepted: 15 November 2010 / Published online: 21 December 2010
