The efficiency of susceptibility-weighted MRI in the differentiation of endometriomas from haemorrhagic ovarian cysts

Bulut E, Eser Bulut, Peker M, Mustafa Peker, Ali Kupeli, Ali Küpeli, Kupeli A, Danisan G, Gurkan Danisan, Gürkan Danışan, Bulut AC, Arzu Coskuner Bulut
Abdominal radiology (New York) · 2021 · vol. 46(11) , pp. 5337–5343 · doi:10.1007/s00261-021-03196-4 · PMID:34313828 · W3186843419
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

This study investigated susceptibility-weighted MRI's efficiency in differentiating endometriomas from hemorrhagic ovarian cysts, finding it highly sensitive and specific.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This retrospective study evaluated susceptibility-weighted MRI (SWI) for differentiating endometriomas from haemorrhagic ovarian cysts in 89 ovarian cystic lesions (57 endometriomas, 32 haemorrhagic cysts) that appeared as complicated cystic lesions on ultrasonography and underwent lower abdominal MRI. Two radiologists blinded to final diagnoses reviewed imaging in consensus, recording T1/T2 signal intensity criteria on conventional MRI and the presence of curved linear or punctate signal void areas on SWI; final diagnoses were based on surgical pathology and radiological-clinical follow-up. SWI identified punctate or curved linear signal voids in 53 of 57 endometriomas (92.9%) and in none of the haemorrhagic cysts, yielding sensitivity 92.9%, specificity 100.0%, and accuracy 95.5%, while some endometriomas lacked conventional MRI criteria. This paper is centrally about endometriosis — it tests SWI criteria to distinguish endometriomas from haemorrhagic ovarian cysts.

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Abstract

ObjectivesThe aim of the study was to investigate the efficiency of susceptibility-weighted magnetic resonance (MR) imaging (SWIs) in differentiating endometriomas from haemorrhagic ovarian cysts.Materials and methodsBetween July 2017 and January 2019, 89 ovarian cystic lesions (57 endometriomas and 32 haemorrhagic cysts) that were identified as complicated cystic lesions on ultrasonography (US) and underwent lower abdominal MRI with susceptibility weighting were retrospectively evaluated. Final diagnoses were obtained with surgical pathological correlation and radiological-clinical follow-up. Two radiologists blinded to the final diagnoses retrospectively reviewed the images in consensus. The signal intensity on T1- and T2-weighted images and curved linear or punctate signal void areas on SWI were noted for the presence of lesions.ResultsForty of the 57 endometriomas demonstrated the defined MRI criteria, including a cystic hyperintensity on T1-weighted images and hypointensity on T2-weighted images. The remaining 17 lesions did not demonstrate these criteria on conventional MR images. SWI showed punctate or curved linear signal void areas in 53 of 57 endometriomas (92.9%) and none of the haemorrhagic cysts. The sensitivity, specificity and accuracy of SWI in differentiating endometrioma from haemorrhagic cyst were 92.9%, 100.0%, and 95.5%, respectively.ConclusionsThe addition of the SWI sequence to conventional MRI can help distinguish endometriomas from haemorrhagic ovarian cysts.
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Abstract

Objectives The aim of the study was to investigate the efficiency of susceptibility-weighted magnetic resonance (MR) imaging (SWIs) in differentiating endometriomas from haemorrhagic ovarian cysts.

Materials and methods

Between July 2017 and January 2019, 89 ovarian cystic lesions (57 endometriomas and 32 haemorrhagic cysts) that were identified as complicated cystic lesions on ultrasonography (US) and underwent lower abdominal MRI with susceptibility weighting were retrospectively evaluated. Final diagnoses were obtained with surgical pathological correlation and radiological-clinical follow-up. Two radiologists blinded to the final diagnoses retrospectively reviewed the images in consensus. The signal intensity on T1- and T2-weighted images and curved linear or punctate signal void areas on SWI were noted for the presence of lesions.

Results

Forty of the 57 endometriomas demonstrated the defined MRI criteria, including a cystic hyperintensity on T1-weighted images and hypointensity on T2-weighted images. The remaining 17 lesions did not demonstrate these criteria on conventional MR images. SWI showed punctate or curved linear signal void areas in 53 of 57 endometriomas (92.9%) and none of the haemorrhagic cysts. The sensitivity, specificity and accuracy of SWI in differentiating endometrioma from haemorrhagic cyst were 92.9%, 100.0%, and 95.5%, respectively.

Conclusions

The addition of the SWI sequence to conventional MRI can help distinguish endometriomas from haemorrhagic ovarian cysts. Similar content being viewed by others

References

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endometriosis

MeSH descriptors

Endometriosis Endometriosis Ovarian Cysts Ovarian Cysts Ovarian Neoplasms Female Humans Magnetic Resonance Imaging Retrospective Studies

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