The usefulness of diffusion-weighted MRI in the differentiation between focal uterine endometrial soft tissue lesions

• Published in: Egyptian journal of radiology and nuclear medicine 2019-12, Vol.50 (1), p.102-8
• Main Authors: Mansour, Tarek Mohamed M, Ahmed, Yasser Abd Al-aal, Ahmed, Ghada Abd El-Razik
• Format: Article
• Language: English
• Subjects: Cancer; Drunk driving; DWMRI; Endometrial mass lesions; Endometrium; Histopathology; Hyperplasia; Magnetic resonance imaging; Medical diagnosis; Metastasis; Polyps; Vagina
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-019-0076-x

Background Several endometrial conditions may be challenging for radiologists due to the overlap of imaging features and variable endometrial pathologies. MRI with DWI is the most commonly used imaging technique for the diagnosis and characterization of endometrial focal lesions. Results The 50 studied lesions were classified according to their histopathological results into the benign group (28 lesions, 56%) and the malignant group (22 lesions, 44%). Conventional MRI could correctly diagnose 39 of the 50 lesions (22/28 benign and 17/22 malignant lesions), achieving a sensitivity of 77.27%, specificity of 78.56%, accuracy of 78%, predictive positive value (PPV) of 73.91%, and negative positive value (NPV) of 81.48%. By combining DWI and apparent diffusion coefficient (ADC) value mapping at a high b value (b = 1000) in MRI, we could correctly diagnose 47 of the 50 lesions (26/28 benign and 21/22 malignant lesions), with increased sensitivity (95.45%), specificity (92.86%), accuracy (94%), PPV (91.3%), and NPV (96%). Conclusion Combining DWI with ADC mapping at a high b value in pelvic MRI examination is valuable in differentiating endometrial focal lesions with increased diagnostic sensitivity, specificity, and accuracy. Aim of the work This study aimed to evaluate the role of DWI in the diagnosis and differential diagnosis of benign and malignant focal endometrial masses.