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Value of magnetic resonance imaging in the diagnosis of ovarian thecomas/fibrothecomas
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Abstract
SUMMARY
Purpose: Our study aims to study the value of conventional magnetic resonance imaging (MRI) combined with DWI and Dynamic technique in the diagnosis of thecomas/fibrothecomas and differential diagnosis benign
with malignant ovarian tumors.
Material and method: In total, 68 thecomas/fibrothecomas, 63 malignant ovarian tumors were included in our study. All patients underwent conventional MRI, DWI in 79 cases and Dynamic enhancement (DCE) in 14 cases. The clinical features and characteristics of conventional MRI, DWI and DCE of these two groups were analyzed. Apparent diffusion coefficient (ADC) values, Tmax, MRE were measured and compared between groups. Univariate analysis, multivariate logistic regression
analysis were analyzed. Sensitivity (Se), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV) were included.
Results: All the fibromas/fibrothecomas showed hypo-isointensity on T1 weighted imaging (T1WI) and 77.9 % lesions showed hypo- to isointensity on T2 weighted imaging (T2WI). After administration of contrast medium, 82,3% tumors appeared as minor to mild enhancement, 71,4% benign tumor had type 1 curve, Tmax cutoff were 230s with Se and Sp 71,4%. MRE were not already measured because of few cases. On DWI, 68,4% fibromas/fibrothecomas manifested no signal intensity or low
signal intensity. The ADC cutoff were 1.07 x 10-3 mm2/s to differentiate benign from malignant ovarian tumors. Multivariate logistic regression analysis showed that only T2WI and ADC were the important indicators in discriminating fibromas/fibrothecomas or benign tumors from malignant ovarian tumors.
Conclusion: The combination of DWI, DCE with conventional MRI is of great value in the diagnosis of fibromas/fibrothecomas and differentiation benign ovarian tumors from malignant ovarian tumors
Article Details
Keywords
Fibromas/fibrothecomas, Conventional magnetic resonance imaging, Diffusion-weighted imaging, Apparent diffusion coefficient value, Dynamic contrast enhancement
References
1. Allen B. C., Hosseinzadeh K., Qasem S. A., et al. (2014). “Practical approach to MRI of female pelvic masses”. AJR Am J Roentgenol, 202 (6), trang. 1366-75.
2. Bakir B., Bakan S., Tunaci M., et al. (2011). “Diffusion-weighted imaging of solid or predominantly solid gynaecological adnexial masses: is it useful in the differential diagnosis?”. Br J Radiol, 84 (1003), trang. 600-11.
3. Chen J., Wang J., Chen X., et al. (2017). “Computed tomography and magnetic resonance imaging features of ovarian fibrothecoma”. Oncol Lett, 14 (1), trang. 1172-1178.
4. Chung B. M., Park S. B., Lee J. B., et al. (2015). “Magnetic resonance imaging features of ovarian fibroma, fibrothecoma, and thecoma”. Abdom Imaging, 40 (5), trang. 1263-72.
5. Dhanda S., Thakur M., Kerkar R., et al. (2014). “Diffusion-weighted imaging of gynecologic tumors: diagnostic pearls and potential pitfalls”. Radiographics, 34 (5), trang. 1393-416.
6. Elzayat W. A., El-Kalioubie M., Abdel-Naby M. M., et al. (2017). “The role of dynamic contrast enhanced MR imaging in the assessment of inconclusive ovarian masses”. The Egyptian Journal of Radiology and Nuclear Medicine, 48 (4), trang. 1159-1169.
7. Fujii S., Kakite S., Nishihara K., et al. (2008). “Diagnostic accuracy of diffusion-weighted imaging in differentiating benign from malignant ovarian lesions”. J Magn Reson Imaging, 28 (5), trang. 1149-56.
8. Kato H., Kanematsu M., Ono H., et al. (2013). “Ovarian fibromas: MR imaging findings with emphasis on intratumoral cyst formation”. Eur J Radiol, 82 (9), trang. e417-21.
9. Numanoglu C., Kuru O., Sakinci M., et al. (2013). “Ovarian fibroma/fibrothecoma: retrospective cohort study shows limited value of risk of malignancy index score”. Aust N Z J Obstet Gynaecol, 53 (3), trang. 287-92.
10. Roth L. M. (2006). “Recent advances in the pathology and classification of ovarian sex cord-stromal tumors”. Int J Gynecol Pathol, 25 (3), trang. 199-215.
11. Shinagare A. B., Meylaerts L. J., Laury A. R., et al. (2012). “MRI features of ovarian fibroma and fibrothecoma with histopathologic correlation”. AJR Am J Roentgenol, 198 (3), trang. W296-303.
12. Takeuchi M., Matsuzaki K., Nishitani H. (2010). “Diffusion-weighted magnetic resonance imaging of ovarian tumors: differentiation of benign and malignant solid components of ovarian masses”. J Comput Assist Tomogr, 34 (2), trang. 173-6.
13. Thomassin-Naggara I., Toussaint I., Perrot N., et al. (2011). “Characterization of complex adnexal masses: value of adding perfusion- and diffusion-weighted MR imaging to conventional MR imaging”. Radiology, 258 (3), trang. 793-803.
14. Troiano R. N., Lazzarini K. M., Scoutt L. M., et al. (1997). “Fibroma and fibrothecoma of the ovary: MR imaging findings”. Radiology, 204 (3), trang. 795-8.
15. Tyagi S. P., Maheswari V., Tyagi N., et al. (1993). “Solid tumours of the ovary”. J Indian Med Assoc, 91 (9), trang. 227-30.
16. Valentini A. L., Gui B., Micco M., et al. (2012). “Benign and Suspicious Ovarian Masses-MR Imaging Criteria for Characterization: Pictorial Review”. J Oncol, 2012, trang. 481806.
17. Yin B., Li W., Cui Y., et al. (2016). “Value of diffusion-weighted imaging combined with conventional magnetic resonance imaging in the diagnosis of thecomas/fibrothecomas and their differential diagnosis with malignant pelvic solid tumors”. World J Surg Oncol, 14.
18. Zhang Z., Wu Y., Gao J. (2015). “CT diagnosis in the thecoma-fibroma group of the ovarian stromal tumors”. Cell Biochem Biophys, 71 (2), trang. 937-43.
19. 2009). “MRI and CT of the Female Pelvis”. Radiology, 251 (3), trang. 650-650.
20. Shinagare A. B., Meylaerts L. J., Laury A. R., et al. (2012). “MRI Features of Ovarian Fibroma and Fibrothecoma With Histopathologic Correlation”. American Journal of Roentgenology, 198 (3), trang. W296-W303.