[Diffusion-weighted MR imaging of the female pelvis].
Due to technical advances (parallel imaging and new phased-array coils), diffusion-weighted MR imaging can be used to image the female pelvis. Diffusion-weighted (b=1000) images are now acquired as a complement to conventional sequences (T2W, dynamic T1W images after intravenous injection of gadolinium). Diffusion weighted imaging improves the detection of small uterine tumors and the visualization of small implants of peritoneal carcinomatosis, which could play a significant role for tumor staging. It is helpful for characterization of complex ovarian tumors: the absence of hyperintensity on b=1000 diffusion-weighted images has an excellent positive predictive value for a benign etiology. It could also be helpful to characterize endometrial lesions, to differentiate between endometrial polyp and carcinoma when hysteroscopy is not possible, and to differentiate uterine fibroid from sarcoma. Finally, diffusion-weighted imaging could be helpful to assess the response of uterine tumors to therapy and could confirm a good outcome following uterine artery embolization of uterine fibroids.
Service de radiologie de l'Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France. isabelle.thomassin@gmail.fr
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Thomassin-Naggara
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Fournier
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Roussel
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Marsault
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Bazot
D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005682:Gadolinium; D005831:Genital Diseases, Female / Q000175:diagnosis*; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010534:Peritoneal Neoplasms / Q000175:diagnosis; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis
D003287:Contrast Media; D005682:Gadolinium