title: Metabolic changes in pelvic lesions: findings at proton MR spectroscopic imaging.
abstract: OBJECTIVE
  The purpose of this study is to investigate the in vivo magnetic resonance spectroscopic (MRS) features of pelvic lesions using long echo time and to characterize the spectral patterns of various pathological entities.
  
  
  METHODS
  17 patients with surgically and histopathologically confirmed pelvic lesions underwent long echo-time MRS, and the results obtained were analyzed. Before laparotomy, choline (Cho), lactate, lipid and creatine (Cr) levels of all lesions were measured by single voxel MRS (point-resolved spectroscopy technique, TE 136 ms). Voxels were placed in the center of the lesions. The MRS results of lesions were compared with the final histopathological diagnoses.
  
  
  RESULTS
  Spectroscopy analysis of serous, mucinous and undifferentiated carcinoma of the ovary revealed Cho, lactate and lipid signals, but granulosa-theca cell tumor showed only a lipid signal. The Cho signal was obtained from only 3 patients with mature cystic teratoma but none of the other benign ovarian tumors and pelvic abscesses. A lipid signal was detected in 3 patients diagnosed with pelvic abscess and all benign ovarian tumors. In addition to the lipid signal, a lactate signal was detected in the spectra of two pelvic abscesses. One case of endometrioma and 1 case of teratoma did not show any signal.
  
  
  CONCLUSIONS
  MRS demonstrates significant differences in metabolite concentration between benign and malignant ovarian tumors and pelvic abscesses. MRS may therefore be helpful in the differential diagnosis of adnexal lesions.
authors.affiliation: Department of Obstetrics and Gynecology, Inonu University Medical Faculty, Malatya, Turkey. shascalik@inonu.edu.tr
authors.forename: Seyma
authors.initials: S
authors.lastname: Hascalik
authors.forename: Onder
authors.initials: O
authors.lastname: Celik
authors.forename: Kaya
authors.initials: K
authors.lastname: Sarac
authors.forename: M Mutlu
authors.initials: MM
authors.lastname: Meydanli
authors.forename: Alpay
authors.initials: A
authors.lastname: Alkan
authors.forename: Bulent
authors.initials: B
authors.lastname: Mizrak
mesh_terms: D018784:Abdominal Abscess / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D003884:Dermoid Cyst / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000378:metabolism / Q000473:pathology; D005260:Female; D016586:Granular Cell Tumor / Q000378:metabolism / Q000473:pathology; D006801:Humans; D050356:Lipid Metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000378:metabolism / Q000473:pathology; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology; D010386:Pelvic Neoplasms / Q000378:metabolism* / Q000473:pathology*; D011522:Protons; D013724:Teratoma / Q000378:metabolism / Q000473:pathology
chemical_list: D011522:Protons; D003401:Creatine; D002794:Choline