Role of MRI in the Evaluation of Adnexal Masses - A Prospective Study

Author(s): Aswini Jyothi Jayam Subramanyam1, Surya Prakash Cheedalla2, Vanaja Bulkapuram3, Veena Madireddy4, Vijaya Kumari5

Among all the disorders of female reproductive system, adnexal masses are one
of the most common disorders. The main purpose of the study was to evaluate an
adnexal mass and to differentiate the mass as benign or malignant and facilitate
selection of appropriate treatment algorithm. For few benign lesions, radiological
follow-up is very suitable for further management and additional follow-up may
not be useful when an imaging abnormality is not found.
Our study was conducted in Osmania General Hospital and its allied hospital
named Government Maternity Hospital, Hyderabad, on about 150 patients. This is
an institution-based, multicentric, cross-sectional, prospective, analytical study. All
clinically suspected female patients with adnexal masses referred to the
Department of Radiodiagnosis were evaluated. These patients were first subjected
to ultrasonography, followed by magnetic resonance imaging (MRI) (plain and
contrast wherever required). MRI findings were compared with ultrasonography.
These findings were compared with operative findings and histopathological
findings, wherever performed.
In the present study, females in the age group of 21 – 40 years showed majority
of pelvic lesions - 81 (54 %). Most of the pelvic masses were arising from the
ovary - 102 (68 %). Majority of the adnexal lesions on MRI were benign in nature
- 132 (88 %). MRI showed a sensitivity of 100 %, specificity of 97.7 %, and a
positive predictive value of 83 %, & a negative predictive value of 100 %.
In practice, ultrasonography (USG) is the primary modality for diagnosing the
pelvic mass. MRI is superior to ultrasound and can be used as problem solving
technique in the assessment of pelvic mass. The multiplanar imaging capability
allows accurate identification of origin of mass and characterisation of mass. This
is helpful to the preoperative planning of sonographically detected mass and
avoids surgery in possible cases. MRI is the technique of choice for staging,
treatment planning and post treatment follow-up of pelvic malignancies.