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Ovarian carcinoma with diffusion weighted imaging

Case Study
Dr. García Prado, Francisco Javier MD Anderson International Spain • Spain

Patient history

Patient is a 33-year-old woman presenting various episodes of bilateral adnexal cysts.

In a routine gynecologic ultrasonography a dominant left anexial cyst was seen. MRI was then performed at MD Anderson International, Madrid, Spain.

Imaging parameters

The MRI exam was performed on Ingenia 1.5T. 

The patient was asked to adhere to eight hours fasting prior to examination. No other preparation was performed.

 T2W mDIXON TSE THRIVE
T2W mDIXON TSE
THRIVE
 DWI  b0, b1000, b1500 and ADC
DWI b0, b1000, b1500 and ADC


T2-weighted mDIXON TSE imaging provides homogeneous fat suppression and a solid nodule within a left ovarian cyst. A solid pole within a unilocular ovarian cyst is morphologic characteristic of malignancy.

Mild post-gadolinium enhancement supports a suspicion of malignancy in the solid component of the lesion.

On diffusion weighted imaging the lesion shows high signal on the high b-value  images b1000 and b1500 and low signal in apparent diffusion coefficient (ADC) map. It correlates with the cellularity degree in the solid pole of the lesion (asterisk).

Diagnosis

Mucinous ovarian cystoadenocarcinoma.

Clinical significance

MRI helps to visualize the solid pole within a unilocular ovarian cyst, which is a morphologic characteristic of malignancy.



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Oct 8, 2014

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Case Study
Ingenia 1.5T
Release 5
Omega
cyst, dStream, DWI, mDIXON TSE, Ovaries, Women's health
 

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