Endometrial cysts: diagnosis with MR imaging.

Area of Science:

• Radiology
• Gynecologic Imaging

Background:

• Endometrial cysts are common gynecologic masses.
• Accurate differentiation from other adnexal masses is crucial for appropriate patient management.

Purpose of the Study:

• To prospectively evaluate the diagnostic value of 1.5-Tesla magnetic resonance (MR) imaging in diagnosing endometrial cysts.
• To assess MR imaging's ability to differentiate endometrial cysts from other gynecologic masses.

Main Methods:

• Prospective evaluation of 374 female patients with clinically suspected adnexal masses.
• Diagnosis based on T1- and T2-weighted image characteristics, including hyperintensity, homogeneous hyperintensity, hypointense signal (shading), and multiplicity.
• Surgical confirmation in 293 patients and lesion confirmation in 354 lesions.

Main Results:

• MR imaging achieved 90% sensitivity, 98% specificity, and 96% accuracy in diagnosing endometrial cysts.
• Accurate diagnosis of 77/86 endometrial cysts and exclusion in 263/268 other masses.
• Imaging findings suggestive of endometrial cysts included T1 hyperintensity with T2 homogeneous hyperintensity; definitive findings included T1 hyperintensity with T2 hypointensity (shading) or multiple T1 hyperintense cysts.

Conclusions:

• 1.5-T MR imaging is a highly accurate tool for diagnosing endometrial cysts.
• The imaging characteristics observed allow for reliable differentiation from other gynecologic masses.
• MR imaging findings provide a basis for clinical decision-making regarding treatment selection.