Metabolic changes in pelvic lesions: findings at proton MR spectroscopic imaging.
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.
Hascalik
Seyma
S
Department of Obstetrics and Gynecology, Inonu University Medical Faculty, Malatya, Turkey. shascalik@inonu.edu.tr
Celik
Onder
O
Sarac
Kaya
K
Meydanli
M Mutlu
MM
Alkan
Alpay
A
Mizrak
Bulent
B
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
D011522:Protons; D003401:Creatine; D002794:Choline