Magnetic resonance manifestations of hyperreactio luteinalis

Area of Science:

• Radiology
• Oncology
• Gynecology

Background:

• Hyperreactio luteinalis (HL) is a rare, benign ovarian enlargement.
• It is associated with pregnancy or gestational trophoblastic disease.
• HL can mimic ovarian neoplasms on imaging.

Purpose of the Study:

• To evaluate magnetic resonance (MR) findings of HL.
• To differentiate HL from ovarian neoplasms using diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements.

Main Methods:

• Retrospective evaluation of MR findings in 15 HL cases (8 women).
• DWI (b = 0 and 800 s/mm²) was performed in 11 HL cases.
• ADC values of HL ovarian stroma were compared to 18 ovarian cancers.

Main Results:

• HL presented as multilocular cystic masses with septations, resembling mucinous cystic tumors.
• Ovarian stroma in HL showed hyperintensity on DWI.
• Significantly higher ADC values were observed in the ovarian stroma of HL compared to solid portions of ovarian cancers.

Conclusions:

• Ovarian stroma in HL can mimic solid components of mucinous tumors.
• Elevated ADC values in HL stroma, indicative of edema and luteinization, are valuable for diagnosis.
• DWI with ADC measurement can help distinguish HL from ovarian neoplasms.