MR imaging in the evaluation of benign uterine masses: value of gadopentetate dimeglumine-enhanced T1-weighted images.
Forty-six patients with surgically proved disease (115 leiomyomas, 19 cases of adenomyosis, and 14 endometrial polyps) were studied to determine if gadopentetate dimeglumine-enhanced T1-weighted MR images improve the detection and characterization of benign tumors of the uterus. Lesion detection and characterization were assessed separately for each sequence (unenhanced T1-weighted, proton-density-weighted, and T2-weighted and contrast-enhanced T1-weighted images) and for combinations of sequences (unenhanced T1- and T2-weighted images, unenhanced and contrast-enhanced T1-weighted images, and unenhanced T1- and T2-weighted and contrast-enhanced T1-weighted images). In the evaluation of leiomyomas, analysis of all three sequences provided the best detection (92%) and characterization (92%), but the improvement, except when compared with unenhanced T1-weighted images alone, was not statistically significant. The use of contrast medium did not contribute to either tumor detection or characterization. In the evaluation of adenomyosis, T2-weighted images provided significantly better lesion detection and characterization than did either unenhanced or contrast-enhanced T1-weighted images. In the evaluation of endometrial polyps, however, contrast-enhanced T1-weighted images provided significantly better lesion detection and characterization than did unenhanced images. With contrast-enhanced images, the detection rate was 79%, compared with 36% for T2-weighted images and 7% for T1-weighted images. Lesion characterization was the best (73%) when all imaging sequences were analyzed. Our study shows that with conventional spin-echo sequences, the use of contrast-enhanced T1-weighted images does not improve the detection or characterization of uterine leiomyomas or adenomyosis but significantly improves the detection of endometrial polyps.
Hricak
H
H
Department of Radiology, University of California, San Francisco 94143-0628.
Finck
S
S
Honda
G
G
Göranson
H
H
D003287:Contrast Media; D004338:Drug Combinations; D016889:Endometrial Neoplasms / Q000175:diagnosis*; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011127:Polyps / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014594:Uterine Neoplasms / Q000175:diagnosis*
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA