الفهرس 
Ovaries
Classifications of Ovarian TumorsOnly 14 pages are availabe for public view
 |  | from | 128 |  |  |
| | | from | 128 | | |
Abstract
Ovarian tumors; are one of the most common gynecological tumors and is the fifth commonest tumor in women.
Although the final diagnosis of an ovarian tumor is based on the histological examination, it is desirable to preoperatively differentiate benign, and invasive ovarian cancers in order to decide whether surgery is required, and which type of surgery is appropriate. Thus, it can help avoiding unnecessary surgery and help deciding for conservative surgery for young females wishing to preserve childbearing potential.
MRI provides soft tissue characterization based on different signal intensities and contrast uptake in post contrast images. Although being a cost effective choice yet it has the ability for accurate diagnosis, it can replace computed tomography (CT) in some cases.
DWI and Perfusion increase the sensitivity and specificity of the modality.
Perfusion is used to characterize the tumor by vasculature within a tumor. Thus, malignant lesions enhance with contrast quickly and have more intense signals, compared to benign lesions, due to the extensive vascular system associated with malignant tumors.
Perfusion MR provides advanced capabilities for functional imaging, Post-processing can be carried out either from a visual analysis and by description of the curves Therefore, it can be used to improve diagnostic accuracy, grade tumors, offer guidance for surgical intervention and drug treatment and determine early response to therapy.
The addition of Perfusion imaging enabled us to increase the diagnostic confidence of conventional MR imaging in up to 25% of tumors.
DWI depends on the idea of the cell packing causing restricted movement in high cellular lesion. DW imaging also contributed to the differentiation of benign from malignant masses, as previously described with use of the absence of high signal intensity within the solid component at b = 1000 sec/mm 2 to predict benignity. DW imaging allowed an increase in the diagnostic confidence rate of up to 16%.
In this review, we present the development of perfusion and diffusion analysis to characterize sonographically indeterminate adnexal masses. Using time intensity curve analysis and visual assessment of DW signal, functional criteria help the radiologist to improve lesion characterization especially for benign lesions and should help the clinician to avoid unnecessary surgeries.