title: Critical evaluation of the specificity of MRI and TVUS for differentiation of malignant from benign adnexal lesions.
abstract: The aim of our work was to study the specificity of MRI in comparison with transvaginal US for differentiation of malignant from benign adnexal lesions. A total of 67 patients with clinically suspicious adnexal lesions were evaluated by MRI. Transaxial and coronal images were acquired using T1-weighted sequences before and following IV contrast and T2-weighted sequences. In all patients transvaginal ultrasound examinations (TVUS) were performed. For both imaging modalities each lesion was classified separately as either benign or malignant according to previously published criteria. Pathologic findings were available in 65 cases. Both MRI and TVUS correctly classified the 12 malignant lesions (sensitivity 100 %). Specificity (MRI: 78.2 %, TVUS: 65.5 %) and accuracy (MRI: 82 %, TVUS: 71.6 %) were higher with MRI than with TVUS, but differences were statistically not significant (p = 0.18 and p = 0.20, chi-square test). There was agreement/disagreement between findings of MRI and US in 52/15 lesions. The macroscopic criteria for malignancy are unspecific and result in a limitation of the specificity of both MRI and TVUS. The MRI technique is a valuable adjunct to TVUS by enabling further clarification of adnexal tumors with equivocal complex or solid vaginal sonographic findings.
authors.affiliation: Department of Diagnostic Radiology, University of Kiel, Arnold-Heller-Strasse 9, D-24 105 Kiel, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Reuter
authors.forename: J
authors.initials: J
authors.lastname: Steffens
authors.forename: U
authors.initials: U
authors.lastname: Schüppler
authors.forename: J
authors.initials: J
authors.lastname: Lüttges
authors.forename: C
authors.initials: C
authors.lastname: Muhle
authors.forename: G
authors.initials: G
authors.lastname: Brinkmann
authors.forename: A
authors.initials: A
authors.lastname: Maschek
authors.forename: D
authors.initials: D
authors.lastname: Weisner
authors.forename: R
authors.initials: R
authors.lastname: Spielmann
authors.forename: M
authors.initials: M
authors.lastname: Heller
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003287:Contrast Media; D003937:Diagnosis, Differential; D018450:Disease Progression; D019160:Endosonography; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014621:Vagina / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media