Purpose: Preoperative assessment of adnexal lesions as benign or malignant by MRI with gastrointestinal and intravenous contrast.
Methods: 46 patients with benign (n = 42) and malignant (n = 4) cystic adnexal tumours underwent MRI of the pelvis. Transaxial and coronal images were acquired using conventional T1- and T2-weighted SE-sequences after oral administration of superparamagnetic iron oxide particles (Ferristene). Additional T1-weighted SE-images were obtained immediately following gadodiamide (Gd DTPA-BMA) injection.
Results: MRI correctly classified the four malignant lesions, whereas nine histologically benign lesions were misdiagnosed as malignant. Intravenous contrast yielded a superior delineation of intratumor architecture.
Conclusion: Due to exclusion of solid structures. MRI with oral and i.v. contrast enables to dismiss suspected malignity in cystic adnexal lesions. Because of the non-specificity of the macroscopic criteria of dignity, the MR diagnosis "malignity" is of limited value.