The accuracy of pelvic magnetic resonance imaging in the diagnosis of ovarian malignancy in Iraqi patients in comparison with histopathology

  • Saba Q . Issa Ministry of Health, Bakooba Hospital
  • khaleel I. Mohson iraqi national cancer research center, university of Baghdad
  • Nawras K. Fadhil Dept. of Clinical biochemistry, College of Pharmacy/Al- MustansyriahUniversity.
Keywords: Keywords: ovarian cancer, adnexal lesion, Magnetic Resonance Imaging, diffusion-weighted imaging, Histopathology.

Abstract

Background: Ovarian malignancy is considered to score the highest fatality among women due to lack of significant symptoms. Early diagnosis and treatment lead to good prognosis. Magnetic resonance imaging (MRI) plays a major role in the diagnosis by detecting the lesions and assessing their appearance and consistency.

Objective: To determine the accuracy of MRI in the diagnosis of ovarian malignancy and comparing this to histopathology as a gold standard test.

Patients and methods: A follow up study was conducted in the MRI unit of the Radiology Department in Baghdad Teaching Hospital / Baghdad Medical City Complex during the period from 1st of February to 31st of December, 2017 on a group of thirty women with clinically suspected adnexal mass(es). All patients were examined with MRI including the diffusion-weighted imaging. Surgical specimens were taken for histopathology assessment.

Results: A total of 30 women with adnexal mass were included in this study, with a mean age of 46.8±14.9 years. The MRI T1W image of the cystic part was dark in (60%), while the T2W image of the cystic part was bright (80%), T2W of the solid part was bright in (53.3%), T2W fat saturation of the solid part was bright in the majority (73.3%). T1W fat suppression contrast-enhanced of the solid part was avid in 66.7% of women with an adnexal mass; DWI of the solid part was bright in (76.7%). The mean apparent diffusion coefficient (ADC) value by MRI for women with adnexal mass was 0.9±0.3x103 mm2/sec. Histopathology mainly revealed mucinous cystadenocarcinoma in (10%) and low-grade serous adenocarcinoma in (10%).Validity of the results of MRI regarding malignant adnexal mass were sensitivity (90.9%), specificity (75%), +ve predictive value (90.9%), -ve predictive value (75%) and accuracy (86.6%). The appropriate cutoff value for apparent diffusion coefficient in differentiation between malignant and benign adnexal mass was 0.97 with 100% sensitivity and 90.9% specificity.

Conclusions: MRI and diffusion-weighted imaging is a valid and reliable technique in the diagnosis and characterization of ovarian malignancy.

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Published
2019-05-12
How to Cite
1.
Issa S, Mohson khaleel, Fadhil N. The accuracy of pelvic magnetic resonance imaging in the diagnosis of ovarian malignancy in Iraqi patients in comparison with histopathology. JFacMedBagdad [Internet]. 12May2019 [cited 7May2021];60(4):202-7. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/479