MR evaluation of clinically suspected adnexal masses

Our goal was to determine the sensitivity, specificity, predictive value, and accuracy of pelvic MRI in the prospective evaluation of women with a clinically suspected pelvic mass.

One-hundred three patients with clinically suspected pelvic masses were prospectively evaluated by pelvic MRI. Masses were analyzed for size, location, morphological characteristics, and signal behavior. Masses were classified as benign, malignant, or indeterminate and in every case an attempt was made to generate a specific diagnosis according to previously reported characteristic MR appearances. Surgical follow-up was obtained within 3 months of MRI examination for all patients, excepting 11 patients with typically appearing leiomyomas.

One hundred twenty pelvic masses were confirmed. Magnetic resonance was 100% sensitive and 99% specific in prospectively diagnosing dermoids, 96% sensitive and 100% specific in diagnosing subserosal leiomyomas, and 92% sensitive and 91% specific in diagnosing endometriomas.

When physical examination or ultrasound examination is inconclusive, pelvic MRI can aid in the evaluation of women with a suspected pelvic mass. By identifying these common benign gynecologic conditions, unnecessary surgery can be avoided.