Validation of magnetic resonance relaxometry R2 value and cyst fluid iron level for diagnosis of ovarian endometrioma

Magnetic resonance (MR) R2 relaxometry is a safe, noninvasive diagnostic modality for the evaluation of iron levels in the contents of ovarian cysts. The study aims to investigate the sensitivity and specificity of the two methods, R2 value and iron level, in diagnosing OMA patients in the validation set.

A prospective cohort study was conducted from 2013 to 2019. We investigated how R2 value was affected by iron-related compounds, antioxidants and bioelements in the cysts.

The sensitivity and specificity of CF iron-based diagnosis of OMA was 96.6% and 95.4%, respectively. The sensitivity and specificity for R2 value in diagnosing OMA were 86.2% and 70.7%, respectively. The outcomes of the two tests were highly correlated (r = 0.758; P <0.001). The R2 value was positively correlated with CF levels of iron-related compounds and antioxidants. The R2 value was affected not only by iron ions but also by calcium ions.

Preoperative MR relaxometry may provide a noninvasive alternative to CF iron test in diagnosing OMA. The presence of paramagnetic cations in the cyst may be associated with reduced specificity.