PREOPERATIVE DIFFERENTIAL-DIAGNOSIS OF AD NEXAL LESIONS - DOUBLE CONTRAST-MRI

Purpose: Preoperative assessment of adnexal lesions as benign or malig nant by MRI with gastrointestinal and intravenous contrast. Methods: 4 6 patients with benign (n = 42) and malignant (n = 4) cystic adnexal t umours underwent MRI of the pelvis. Transaxial and coronal images were acquired using conventional T-1- and T-2-weighted SE-sequences after oral administration of superparamagnetic iron oxide particles (Ferrist ene). Additional T-1-weighted SE-images were obtained immediately foll owing gadodiamide (Gd DTPA-BMA) injection. Results: MRI correctly clas sified the four malignant lesions, whereas nine histologically benign lesions were misdiagnosed as malignant. Intravenous contrast yielded a superior delineation of intratumoural architecture. Conclusion: Due t o exclusion of solid structures, MRI with oral and i.v. contrast enabl es to dismiss suspected malignity in cystic adnexal lesions. Because o f the non-specificity of the macroscopic criteria of dignity, the MR d iagnosis ''malignity'' is of limited value.