Magnetic resonance imaging findings in patients with benign and malignant ovarian masses versus pathologic outcomes

Abstract

Background: The results of the former study confirmed the accuracy of magnetic resonance imaging (MRI) in determining the origin and content of ovarian masses. The present study aimed to evaluate the diagnostic value of MRI in differentiating benign and malignant ovarian masses in women. Materials and Methods: This was a cross-sectional study. All candidates for surgery to remove ovarian masses were selected to participate in this study. They underwent MRI with gadolinium before the surgery. MRI images were reviewed by an experienced radiologist who was aware of the ovarian mass found in pelvic ultrasonography (US). A thick-enhancing wall, mural nodules, septations, and internal enhancement within the mass were reviewed by the radiologist. Mass specimens were examined in the laboratory by an experienced pathologist to determine malignancy or benignancy of the masses. Pathological findings were compared with MRI results. Results: there was no significant difference between MRI findings and pathology denoted by benign and malignant (P = 0.06), but results showed a significant difference between US and pathology (P = 0.002). In MRI findings related to a thick-enhancing wall (P = 0.18), internal enhancement (P = 0.18), and pelvic fluid (P = 1.00), no significant difference was seen in benign or malignant masses. However, in findings related to septation, all cases had malignant reports (P = 0.006), and in mural nodule, 80 had malignant reports (P = 0.006). CA-125 blood level in patients with benign masses (1.72 +/- 0.97) was significantly less than patients with malignant masses (3.20 +/- 0.83) (P < 0.001). Conclusion: We showed that MRI has better results in diagnosing adnexal masses and their characteristics compared to simple ultrasound imaging based on pathological studies.