Differentiation of Endometriomas from Hemorrhagic Cysts at Magnetic Resonance: The Role of Quantitative Signal Intensity Measurements

Roxana-Adelina Lupean, Paul-Andrei Ștefan, Andrei Lebovici, Csaba Csutak, Georgeta Mihaela Rusu, Mihaela Rusu, Carmen Mihaela Mihu
Current medical imaging · 2020 · vol. 17(4) , pp. 524–531 · doi:10.2174/1573405616999201027211132 · W3096258761
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Quantitative T1-T2 signal intensity measurements on MRI effectively differentiate endometriomas from hemorrhagic cysts, outperforming subjective "T2 shading" evaluation, while diffusion parameters did not distinguish between the two.

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Abstract

Background: Endometriomas and functional hemorrhagic cysts (FHCs) are a common gynecological encounter. Objective: This study aimed to assess the diagnostic efficiency of magnetic resonance imaging (MRI) using signal intensity measurements in differentiating endometriomas from FHCs. Methods: Forty-six patients who underwent pelvic MRI examinations (endometriomas, n=28; FHCs, n=18) were retrospectively included. The “T2 shading” sign was evaluated subjectively and quantitatively by measuring the T1-T2 signal intensity difference and calculating the percentage of signal decrease between T1 and T2-weighted sequences. The resulted values, along with the measurement of the Apparent Diffusion Coefficient (ADC) and the signal intensity on three diffusion- weighted sequences (DWI) (b 50 , b 400 , and b 800 ), were compared between groups by using the Mann–Whitney U test. Also, the receiver operating characteristic analysis was performed for the statistically significant results (P<0.016), and the area under the curve (AUC) was also calculated. Results: The two quantitative assessment methods showed similar efficiency in detecting endometriomas (P0.86), outperforming the classic subjective evaluation of the “T2 shading” sign (sensitivity, 92.86%; specificity, 66.67%). ADC (P=0.52) and DWI measurements (P=0.49, P=0.74, and P=0.78) failed to distinguish between the two entities. Conclusion: The quantitative analysis and interpretation of the “T2 shading” sign can significantly improve the differential diagnosis between endometriomas and FHCs.

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Condition tags

mesh:D004715

MeSH descriptors

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

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