Ovarian lesions: detection and characterization with gadolinium-enhanced MR imaging at 1.5 T

Magnetic resonance (MR) imaging for detection and characterization of ovarian masses was assessed in 33 patients with a total of 60 lesions. Lesions were characterized prospectively as benign or malignant by using T2-weighted MR images and unenhanced and gadolinium-enhanced T1-weighted MR images. MR imaging findings were compared with results of surgical laparotomy performed for staging of lesions. When malignancy was suspected, staging with MR imaging was performed. MR imaging demonstrated 57 of 60 (95%) surgically proved ovarian masses (34 of 36 were benign, 23 of 24 were malignant). Five significant primary criteria and four ancillary criteria for malignancy were established. For all MR pulse sequences combined, characterization of either type of lesion was correct in 84% of cases (48 of 57) when the five primary criteria were used and 95% (54 of 57) were correct when the four ancillary criteria were added. With gadolinium-enhanced images, correct characterization of malignant lesions increased from 56% to 78% with use of the five primary criteria and from 83% to 100% with use of both sets of criteria. Malignancies were correctly staged with MR imaging in 12 of 16 patients. Staging accuracy was 63% with unenhanced images and 75% with the addition of enhanced images.