ADNEXAL MASSES - ACCURACY OF CHARACTERIZATION WITH TRANSVAGINAL US AND PRECONTRAST AND POSTCONTRAST MR-IMAGING

PURPOSE: To determine the accuracy of transvaginal ultrasound (TVUS) a nd of precontrast and contrast material-enhanced magnetic resonance (M R) imaging in the differentiation of adnexal masses. MATERIALS AND MET HODS: Five blinded readers analyzed images of 80 masses in 72 patients . MR and TVUS images were interpreted in separate sessions. Findings w ere confirmed at surgery or laparoscopy. RESULTS: Higher diagnostic ac curacy was attained with MR imaging in mature cystic teratomas and end ometriomas. However, better accuracy was achieved with contrast-enhanc ed MR imaging and TVUS in simple cysts, cystadenomas, and malignant tu mors because internal details could be visualized. Receiver operating characteristic study indicated that observer confidence was significan tly higher with contrast-enhanced MR imaging than with precontrast MR imaging (P =.011) or TVUS (P =.002) in the differentiation of benign a nd malignant masses. CONCLUSION: Contrast-enhanced MR imaging is super ior to precontrast MR and TVUS imaging in the characterization and dif ferentiation of adnexal masses.