The utility of diffusion-weighted magnetic resonance imaging in differentiation of endometriomas from hemorrhagic ovarian cysts

Balaban, Mehtap; İdilman, İlkay S.; Toprak, Hüseyin; Ünal, Özlem; İpek, Ali; Kocakoç, Ercan

doi:10.1016/j.clinimag.2015.05.003

Cited by 27 publications

(17 citation statements)

References 16 publications

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“…A role for DWI has also been suggested in differentiation of endometriomas from haemorrhagic cysts with significantly lower ADC values in endometriomas when compared with haemorrhagic ovarian cysts at all b values [71]. …”

Section: Resultsmentioning

confidence: 99%

European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis

et al. 2016

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Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion. This work was performed by a group of radiologists from the European Society of Urogenital Radiology (ESUR), experts in gynaecological imaging and a gynaecologist expert in methodology. The group discussed indications for MRI, technical requirements, patient preparation, MRI protocols and criteria for the diagnosis of pelvic endometriosis on MRI. The expert panel proposed a final recommendation for each criterion using Oxford Centre for Evidence Based Medicine (OCEBM) 2011 levels of evidence.Key Points• This report provides guidelines for MRI in endometriosis.• Minimal and optimal MRI acquisition protocols are provided.• Recommendations are proposed for patient preparation, best MRI sequences and reporting criteria.Electronic supplementary materialThe online version of this article (doi:10.1007/s00330-016-4673-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

European society of urogenital radiology (ESUR) guidelines: MR imaging of pelvic endometriosis

et al. 2016

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“…In addition, follicle cysts (which can reach up to 5 cm in diameter) can present with high SI in all DWI sequences, even those with high b values, and concomitant high SI on the ADC map-i.e., the "T2-shine through" effect ( 24 ) . When it comes to adnexal lesions, transvaginal ultrasound continues to be the first-line imaging modality, because it is affordable, is fast, and efficiently characterizes most such lesions ( 4 - 6 , 8 , 9 , 19 , 25 - 31 ) . However, MRI plays a vital role in the characterization and surgical planning of lesions classified as indeterminate on ultrasound ( 3 , 8 , 9 , 19 , 27 - 29 , 32 , 33 ) .…”

Section: Adnexamentioning

confidence: 99%

“…Hemorrhagic cysts occur due to hemorrhage within a functional cyst and tend to reabsorb spontaneously. The sedimented blood of hemorrhagic cysts can show high SI on DWI at b = 1000 s/mm 2 ( Figure 6 ), with the corresponding low SI on ADC map, thereby mimicking malignant lesions ( 5 , 9 , 30 , 37 ) .…”

Section: Blood-filled Cystsmentioning

confidence: 99%

“…The use of diffusion-weighted imaging (DWI) in magnetic resonance imaging (MRI) of the pelvis has become more widespread in recent years. Stronger diffusion gradients and faster imaging techniques have been developed, particularly after the introduction of parallel imaging, which provided high-quality DWI of the body with substantially fewer motion artifacts ( 1 - 9 ) .…”

Section: Introductionmentioning

confidence: 99%

“…DWI of the pelvis is now routinely used, allowing tissue characterization at a microscopic level, based on the Brownian motion of water molecules, when two diffusion gradients are added to T2-weighted (T2W) sequences ( 1 , 2 , 5 - 7 , 9 - 13 ) . Those two gradients allow the characterization of tissues by respectively dephasing and rephasing the water molecules, the movement of which is restricted by the presence of cell membranes and macromolecules.…”

Section: Introductionmentioning

confidence: 99%

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Pitfalls of diffusion-weighted imaging of the female pelvis

Duarte

Dias

Cunha³

2018

Radiol Bras

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Diffusion-weighted imaging (DWI) is widely used in protocols for magnetic resonance imaging (MRI) of the female pelvis. It provides functional and structural information about biological tissues, without the use of ionizing radiation or intravenous administration of contrast medium. High signal intensity on DWI with simultaneous low signal intensity on apparent diffusion coefficient maps is usually associated with malignancy. However, that pattern can also be seen in many benign lesions, a fact that should be recognized by radiologists. Correlating DWI findings with those of conventional (T1- and T2-weighted) MRI sequences and those of contrast-enhanced MRI sequences is mandatory in order to avoid potential pitfalls. The aim of this review article is the description of the most relevant physiological and benign pathological conditions of the female pelvis that can show restricted diffusion on DWI.

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