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Ando T, Kato H, Kawaguchi M, Furui T, Morishige KI, Hyodo F, Matsuo M. MR findings for differentiating decidualized endometriomas from seromucinous borderline tumors of the ovary. Abdom Radiol (NY) 2020; 45:1783-1789. [PMID: 31960119 DOI: 10.1007/s00261-020-02412-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Decidualized endometriomas (DEs) and seromucinous borderline tumors (SMBTs) exhibit similar MR findings including markedly hyperintense mural nodules within endometriotic cysts on T2-weighted images. The present study aimed to assess the efficacy of MR imaging for differentiating between DEs and SMBTs of the ovary. MATERIALS AND METHODS MR images of 8 DEs and 14 SMBTs were retrospectively assessed and compared according to pathologies. RESULTS With regard to quantitative assessments of mural nodules, the number and signal intensity ratios (SIRs) on T1-weighted images were significantly greater in DEs than in SMBTs (11.0 ± 8.4 vs. 4.3 ± 4.1, p < 0.05 and 2.36 ± 0.56 vs. 1.49 ± 0.27, p < 0.01, respectively), whereas the height was significantly lower in DEs than in SMBTs (4.5 ± 1.4 mm vs. 21.9 ± 11.4 mm, p < 0.01). However, there were no significant differences between DEs and SMBTs in the SIRs on T2-weighted images, SIRs on diffusion-weighted images, and apparent diffusion coefficient values. With regard to qualitative assessments of mural nodules, the lobulated margin, pedunculated configuration, and T2 hypointense core were significantly more frequent in SMBTs than in DEs (71% vs. 0%, p < 0.01; 86% vs. 0%, p < 0.01; and 43% vs. 0%, p < 0.05, respectively). CONCLUSION The number, height, SIRs on T1-weighted images, lobulated margin, pedunculated configuration, and T2 hypointense core of mural nodules within endometriotic cysts were useful MR findings for differentiating DEs from SMBTs.
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Affiliation(s)
- Tomohiro Ando
- Department of Radiology, Gifu University School of Medicine, 1-1Yanagido, Gifu, 501-1194, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University School of Medicine, 1-1Yanagido, Gifu, 501-1194, Japan.
| | - Masaya Kawaguchi
- Department of Radiology, Gifu University School of Medicine, 1-1Yanagido, Gifu, 501-1194, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University School of Medicine, Gifu, Japan
| | - Ken-Ichirou Morishige
- Department of Obstetrics and Gynecology, Gifu University School of Medicine, Gifu, Japan
| | - Fuminori Hyodo
- Department of Radiology, Gifu University School of Medicine, 1-1Yanagido, Gifu, 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Gifu University School of Medicine, 1-1Yanagido, Gifu, 501-1194, Japan
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Kurata Y, Kido A, Moribata Y, Kameyama K, Himoto Y, Minamiguchi S, Konishi I, Togashi K. Diagnostic performance of MR imaging findings and quantitative values in the differentiation of seromucinous borderline tumour from endometriosis-related malignant ovarian tumour. Eur Radiol 2016; 27:1695-1703. [PMID: 27553934 DOI: 10.1007/s00330-016-4533-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of quantitative values and MRI findings for differentiating seromucinous borderline tumours (SMBTs) from endometriosis-related malignant ovarian tumours (MT). METHODS This retrospective study examined 19 lesions from SMBT and 84 lesions from MT. The following quantitative values were evaluated using receiver-operating characteristic analysis: overall and solid portion sizes, fluid signal intensity (SI), degree of contrast-enhancement, and mean and minimum apparent diffusion coefficient (ADC) values of the solid portion. Two radiologists independently evaluated four MRI findings characteristic of SMBT, fluid SI on the T1-weighted image and SI of the solid portion on diffusion-weighted image. The diagnostic values of these findings and interobserver agreement were assessed. RESULTS For diagnosing SMBT, the mean ADC value of the solid portion showed the greatest area under the curve (0.860) (cut-off value: 1.31 × 10-3 mm2/s, sensitivity: 1.00, specificity: 0.61). The T2-weighted image (T2WI) high SI solid portion was the most useful finding, with high specificity and interobserver agreement (sensitivity, 0.58; specificity, 0.95-0.96, kappa = 0.96), followed by T2WI low SI core (sensitivity, 0.48-0.63; specificity, 0.98, kappa = 0.68). CONCLUSION Mean ADC values of the solid portion, T2WI high SI solid portion, and T2WI low SI core were useful for differentiating SMBT from MT. KEY POINTS • SMBT is a newly categorised ovarian tumour often associated with endometriosis. • Differentiation of SMBT from endometriosis-related malignant ovarian tumour is clinically important. • Diagnostic performances of quantitative values and MRI findings were evaluated. • Mean ADC value of the solid portion was the most useful value. • "T2WI high SI solid portion" was the most useful MRI finding.
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Affiliation(s)
- Yasuhisa Kurata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan.
| | - Yusaku Moribata
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Kyoko Kameyama
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Yuki Himoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, Japan
| | - Ikuo Konishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto, 606-8507, Japan
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