Search In this Thesis
   Search In this Thesis  
العنوان
Diagnostic value of MRI in ovarian masses detection and characterization /
المؤلف
Kamel, Ahmed Samir.
هيئة الاعداد
باحث / احمد سمير كامل
مشرف / محمد ثروت محمود سليمان
مشرف / احمد تاج الدين عبدالحفيظ
مشرف / نهلة محمد علي
مناقش / محمد زاكي علي مراد
مناقش / مصطفى هاشم محمد
الموضوع
Magnetic resonance imaging. Ovaries.
تاريخ النشر
2022.
عدد الصفحات
179 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
الأشعة والطب النووي والتصوير
تاريخ الإجازة
30/1/2022
مكان الإجازة
جامعة سوهاج - كلية الطب - الاشعة التشخيصية
الفهرس
Only 14 pages are availabe for public view

from 182

from 182

Abstract

Ovarian cancer is the second most common gynecologic malignancy. characterization of ovarian lesions is of great importance in order to plan adequate therapeutic procedures, and may influence patient’s management. MRI is an essential problem-solving investigation to determine the site of origin of the ovarian mass, to characterize the adnexal mass, and to detect local invasion and distant spread.
This study aimed to perform pelvis MRI to 60 female cases their age ranging from 1 year up to 86 years presented by ovarian masses referred from the OB/GYN out clinic and in patients between September 2019 and September 2020. The study done in MRI unit diagnostic radiology department at Sohag faculty of medicine.
MR examinations were performed on a 1.5-T MR imaging unit (PHILIPS, Achieva 1.5 tesla).
MRI protocol for those patients include the following sequences:
• axial T1-weighted SE (TR/TE:460/10 ms) and axial Fat saturation T1WI was done to confirm the presence of fat by demonstrating signal DROP out.
• Sagittal, coronal and axial T2-weighted fast spin-echo (SE) sequences.
• Axial T1-weighted image after contrast was taken.
• Diffusion weighted images, variable (b) values were done (0, 500, 800 & 1000 s/mm2) were done to get ADC values with TR/TE: 5000/77.
Using the latter sequences we could analysis the images for discrimination between benign and malignancy.
MRI criteria of malignancy are:
Size (more than 6 cm). predominantly solid masses, heterogeneous solid components, cystic tumors with vegetations (> 1 cm) inside, wall thickening (>3 mm), multiple septa (> five) and thick (>3 mm) septa.
The results from the study:
• 46 benign cases: Simple ovarian cysts (21 cases). Hemorrhagic cyst (10 cases), endometrioma (8 cases), ovarian dermoid cyst (4 cases), ovarian torsion (2 cases) and ovarian abscess (1 case).
• 14 malignant case presented as complex ovarian masses.
According to the DWI: 46 benign cases (35 show no restriction and 11 restricted). And all the malignant cases show restriction at DWI.
According the ADC: Calculate the mean, median and standard deviation of the studied patients. Determine the cut-off value 0.89x10-3 mm2/s to differentiate between benign and malignant cases with a sensitivity of 89.1% and a specificity of 92.9%.
Conclusion and recommendation:
• MRI is a good imaging modality in ovarian masses because the property of tissue characterization.
• Certain MRI features and the pattern of enhancement on MRI are helpful in differentiating between benign and malignant ovarian masses.
• A combination of DWI and ADC value with conventional MRI increases the accuracy of MRI to discriminate between benign and malignant lesions.
• Our study recommend cut-off value 0.89x10-3 mm2/s to differentiate between benign and malignant ovarian masses.