Gadolinium-DOTA enhanced MR imaging of adnexal tumors

We conducted a retrospective study to assess the potential of contrast enhanced magnetic resonance (MR) imaging in evaluating adnexal tumors. Sixty patients with a total of 77 pelvic lesions underwent MR imaging at 1.5 T and transabdominal ultrasound (US). Precontrast T1- and T2-weighted and Gd-DOTA enhanced T1-weighted MR images were obtained. Diagnoses were proved by surgery in 57 patients. Of the 77 lesions, 54 masses were of ovarian origin, including 12 malignant disorders. Ultrasound demonstrated the lesions in 92%, whereas the sensitivity of unenhanced T2-weighted and postcontrast MR images was 98 and 96%, respectively. Compared to the T2-weighted images, postcontrast MR imaging showed superior overall tumor delineation, assessment of intratumoral architecture, and definition of tumor origin. Contrast enhancement of tumors did not differ significantly between normal ovary and benign and malignant lesions. All modalities were unable to predict malignancy of complex lesions. Based on our study, US remains the screening modality of choice in the evaluation of adnexal tumors. Contrast enhanced MR imaging may be valuable for assessing complex lesions or when the origin of the mass cannot be determined by US. Using contrast enhanced T1-weighted images instead of T2-weighted images may lead to a significant reduction in acquisition time.