Characterization of hemorrhagic adnexal lesions with MR imaging: blinded reader study.
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This study evaluated MR imaging criteria for differentiating endometriomas from other hemorrhagic adnexal lesions, finding moderate accuracy with a specific lesion characteristic and poor reliability for ancillary findings.
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Abstract
To assess the performance of published criteria for differentiation of endometriomas from other hemorrhagic adnexal lesions with magnetic resonance (MR) imaging, 74 lesions with pathologic proof in 46 patients were evaluated by means of a 1.5-T system with use of conventional T1-weighted and either T2-weighted spin-echo (SE) or fast SE sequences. The MR images were independently presented to each of three blinded readers, and receiver operating characteristic (ROC) curve analysis was performed. The criterion of a cyst with high signal intensity on short repetition time (TR)/echo time (TE) images and shading on long TR/TE images had a mean sensitivity of 68%, mean specificity of 83%, and mean accuracy of 76% for diagnosis of endometrioma. Ancillary findings previously reported to be suggestive of endometrioma (eg, low-signal-intensity rims, adhesions, bowel tethering, and implants) were proved inaccurate and showed low interobserver agreement. ROC analysis showed similar area measurements among the three radiologists for diagnosis of endometrioma. MR imaging had only moderate accuracy in distinction of endometriomas from other hemorrhagic adnexal lesions.
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Cited by (44)
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- Endometriosis - Recent Advances, New Perspectives and Treatments 2021
- Differentiation of Endometriomas from Hemorrhagic Cysts at Magnetic Resonance: The Role of Quantitative Signal Intensity Measurements 2020
- Differentiation of Endometriomas from Ovarian Hemorrhagic Cysts at Magnetic Resonance: The Role of Texture Analysis 2020
- Diagnostic Efficacy of T2 Dark Spot, T2 Dark Rim Signs, and T2 Shading on Magnetic Resonance Imaging in Differentiating Endometriomas From Hemorrhagic Cysts 2019
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- Atypical Sites of Deeply Infiltrative Endometriosis: Clinical Characteristics and Imaging Findings 2018
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- Recommandations de la Société européenne d’imagerie génito-urinaire : IRM de l’endométriose pelvienne 2017
- Imaging modalities for the non-invasive diagnosis of endometriosis 2016
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- Pelvic Endometriosis: Spectrum of Magnetic Resonance Imaging Findings 2015
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- MR Imaging of Endometriosis: Ten Imaging Pearls 2012
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- Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions 2010
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- 10.1016/s1879-8543(19)60537-9 2000
- Endometriomas: Diagnostic Performance of US 1999
- CT and MRI appearances of sarcomatous change in chronic pelvic endometriosis. 1998
- MRI in Predicting the Response of Ovarian Endometriomas to Hormone Therapy 1996
- Endometriosis: Appearance and detection with conventional and contrast‐enhanced fat‐suppressed spin‐echo techniques 1995
- MAGNETIC RESONANCE IMAGING OF BENIGN ADNEXAL CONDITIONS 1994
- Detection and characterization with short TI inversion recovery MR imaging. 1994
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