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Preoperative Diagnosis of Ovarian Tumors with MR Imaging

Comparison with Transvaginal Sonography, Positron Emission Tomography, and Histologic Findings

Andrea Rieber1, Karin Nüssle1, Iris Stöhr2, Dieter Grab2, Sabine Fenchel3, Rolf Kreienberg2, S. N. Reske3 and Hans-Juergen Brambs1

1 Department of Diagnostic Radiology, University of Ulm, Robert-Koch-Str. 8, 89081 Ulm, Germany.
2 Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89081 Ulm, Germany.
3 Department of Nuclear Medicine, University of Ulm, 89081 Ulm, Germany.



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  		Fig. 1A. —53-year-old woman with ovarian cancer. T1-weighted axial enhanced MR image shows cystic solid tumor of left ovary.

 


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  		Fig. 1B. —53-year-old woman with ovarian cancer. Corresponding transvaginal sonogram shows 30 x 40 mm solid portion against lateral wall of unilocular cyst.

 


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  		Fig. 1C. —53-year-old woman with ovarian cancer. Positron emission tomography scan shows increased fluorine-18 marked FDG uptake (arrow) in left adnexal region, which is typical for malignancy.

 


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  		Fig. 2A. —33-year-old woman with histologic confirmation of epithelial ovarian tumor of low malignant potential (so-called borderline tumor). T1-weighted axial enhanced MR image shows cystic tumor of right ovary without contrast enhancement of septa. MR diagnosis was endometrial cyst.

 


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  		Fig. 2B. —33-year-old woman with histologic confirmation of epithelial ovarian tumor of low malignant potential (so-called borderline tumor). Transvaginal sonogram shows multicystic lesion of right ovary. This lesion had no criteria typical for malignancy.

 


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  		Fig. 2C. —33-year-old woman with histologic confirmation of epithelial ovarian tumor of low malignant potential (so-called borderline tumor). Positron emission tomography scan did not show any fluorine-18 marked FDG uptake. Note physiologic FDG accumulation in urinary bladder. Thus, consensus diagnosis was endometrial cyst.

 


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  		Fig. 3A. —38-year-old woman with ovarian tumor on left side. T1-weighted unenhanced axial MR image shows well-circum-scribed inhomogeneous tumor (arrow) with partially bright signal.

 


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  		Fig. 3B. —38-year-old woman with ovarian tumor on left side. MR image after gadopentetate dimeglumine injection and fat suppression shows that tumor (arrow) has loss of signal intensity. Diagnosis was dermoid cyst, which was confirmed by histology.

 

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