KRUKENBERGS TUMOR OF THE OVARY - MR-IMAGING FEATURES

OBJECTIVE. Krukenberg's tumors are metastatic tumors of the ovary, Som e of these tumors had hypointense solid components on T2-weighted MR i mages. The purpose of this study was to evaluate the MR features of Kr ukenberg's tumors and to compare them with those of other solid ovaria n tumors to determine whether hypointense solid components on MR image s were characteristic of Krukenberg's tumors. MATERIALS AND METHODS. T welve patients with 21 surgically proven Krukenberg's tumors of the ov ary were included in the study; the tumors were bilateral in nine and unilateral in three. The NIR images were studied to determine the morp hologic characteristics and signal intensity patterns of the tumors (e specially the presence or absence of hypointense solid components on T 2-weighted images and isointense components on Tf-weighted images), MR findings were correlated with histopathologic results. The MR feature s of 26 additional benign or malignant solid primary ovarian tumors we re reviewed for comparison. RESULTS. Of the 21 Krukenberg's tumors, 14 were mostly solid and seven were entirely cystic or mostly cystic on MR images. All had sharp margins, and the oval configuration was prese rved in 16. Twelve (57%) of the 21 tumors showed various amounts of hy pointense solid components in random distribution or predominantly in the periphery on MR images; pathologically, these components correspon ded to areas of dense collagenous stroma. MR imaging also showed that the cystic components within the masses had either well-defined or ill -defined borders, Multiseptation was noted in two masses. Of the 26 ad ditional primary ovarian tumors, only three showed hypointense solid c omponents on MR images. These included thecoma, fibrothecoma, and poor ly differentiated adenocarcinoma. CONCLUSION. Our findings suggest tha t identification of hypointense solid components within an ovarian mas s on T2-weighted MR images is a characteristic, although not specific, finding for Krukenberg's tumors, especially when the tumors are bilat eral, have sharp margins, and have an oval configuration.