The Value Of MRI In The Diagnosis Of Endometrioma And Ovarian Cysts With Hemorrhage

Objective:To investigate the value of MRI in differentiating endometrioma and hemorrhagic ovarian cyst in female pelvic cavity by means of analyzing the characteristics of MRI signal and morphology features and explore the relationship between the signal intensity and ADC value of the T₂ shading zoon about the two kinds of ovarian cystic lesions.Materials and methods:The clinical data and MR images of 68 patients?50 with endometrioma and 18 with hemorrhagic ovarian cysts?were collected,which were treated in Affiliated Hospital of Taishan Medical University from July 2014 to September 2015.The patients should meet the following requirements:?1?the patients should not suffer from other obvious adnexal diseases?such as ovarian tumor or fallopian tube diseases?.?2?all of the patients were informed consent and were pathologically confirmed within 2 days to 1 week after MR scan.?3?all the ovarian cystic lesions were discovered bleeding during operation or through pathology.The former group suffered from endometrioma?50 patients,age:32.40±8.20 years old?,the latter group suffered from hemorrhagic ovarian cysts?18 patients,age:30.28±10.53 years old?.Compare the two groups of the patients'information below:the axial diameter of lesions in MR imaging,the compartment of the lesions and the homogeneity of T₂ shading zoon.Explore the relationship between the signal intensity and ADC value of the T₂ shading zoon in the two kinds of ovarian cystic lesions.Make sure if the referred features have statistical difference.All of the two kinds of ovarian lesions were diagnosed independently by two experienced clinicians who worked more than 10 years.All the statistical analysis was performed by SPSS19.0.and GraphPad Prism 6.0.P?0.05 is considered as significant statistical difference.Results:1.About the two groups of ovarian cystic lesions,the main signal features are as follow:among 60 endometrioma lesions,50 lesions are of short T₁ signal,28 and 25 endometrioma lesions are of iso-T₂ and long T₂ signal respectively;Among the lesions of 18 ovarian hemorrhagic cysts,10 lesions are of long T₁ signal,8 lesions are of heterogeneous T₁ signal,14 lesions are of heterogeneous T₂ signal.2.The diameters of the lesions of endometrioma and hemorrhagic ovarian cysts in axial MRI are 51.65mm±22.06mm and 40.77mm±9.26mm respectively.3.Among 60 lesions of endometrioma,45 of them are multilocular;among 18 lesions of hemorrhagic ovarian cysts,only one of them is multilocular.There have statistical difference in housing allotment among the two kinds of ovarian cystic lesions.4.There are 52 of endometrioma lesions and 14 of hemorrhagic ovarian cyst lesions with“T₂ shading sign”and there has no statistical difference in the number of the two kinds of lesions which have“T₂ shading sign”?P=0.586?;16 of endometrioma lesions and none of hemorrhagic ovarian cysts lesions have“T₂ dark spot sign”,which have statistical difference?P=0.034?.27 of 60 endometrioma lesions and 3 of 18 hemorrhagic ovarian cysts lesions have the“liquid–liquid level”,which is of statistical difference?P=0.03?.5.Among the lesions of endometrioma and hemorrhagic ovarian cysts with“T₂ shading sign”,there are 43 and 1“T₂ shading sign”respectively are of homogeneous signal,which have significant statistical difference?P=0.000?.6.About the T₂ shading zoon of endometrioma lesions,there has no apparent correlation between the T₁WI signal intensity and ADC values and there has a linear positive correlation between the signal intensity of T₂ FS imaging and ADC values;In contrast,there has a linear negative correlation between the signal intensity of T₁WI,T₂WI FS imaging and ADC values about the T₂ shading zoon of hemorrhagic ovarian cysts.Conclusion:The MR imaging of the endometrioma are mainly of short T₁ signal?isointensity or long T₂ signal;The MR imaging of the patients suffering from hemorrhagic ovarian cysts are mainly of long T₁ signal?long or mixed T₂ signal.The diameters of the two kinds of hemorrhagic cystic lesions in axial MR imaging have statistical difference?P=0.003?.There have statistical differences in housing allotment among the two groups of ovarian cystic lesions.There have statistical difference in the number of the two groups of ovarian lesions which have“T₂ dark spot sign”.The number of the two kinds of ovarian cystic lesions whose“T₂ shading sign”are of homogeneous signal are of great statistical difference.About the T₂shading zoon of endometrioma lesions,there has no apparent correlation between the T₁WI signal intensity and ADC value and there has a linear positive correlation between the signal intensity of T₂ FS imaging and ADC values;In contrast,there has a linear negative correlation between the signal intensity of T₁WI,T₂ FS imaging and ADC values about the T₂ shading zoon of the two kinds of ovarian cysts.