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abstract
Review
Highlights
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- The preponderant contribution of MRI in adnexal mass evaluation is its specificity.
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- Pelvic MRI provides confident diagnosis of a plethora of benign adnexal lesions.
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- Contrast-MRI provides the highest post-test probability of ovarian cancer detection.
Objective
Incidentally
discovered adnexal masses are common, posing a challenging diagnostic
problem due to overlapping imaging features of benign and malignant.
Thus, once an adnexal lesion has been detected, the primary goal of
further imaging is accurate tissue characterization resulting in surgery
only for lesions that are indeterminate or frankly malignant. This
study aims to conduct a systematic review, following the PRISMA guidelines, and critically appraise pelvic MR Imaging as the preferred
advanced second imaging test, as regards detection of ovarian cancer and
assessment of indeterminate adnexal masses, with respect to
pre-operatively improving the assignment of these patients to the
appropriate level of care.
Methods
A
comprehensive computerized systematic literature search of English
language studies was performed (from 2002 to 2012) of PubMed, EMBASE,
Scopus, Evidence Based Medicine Reviews (Cochrane Database and Cochrane
Central Register of Controlled Trials), and Google Scholar. Relevant
article reference lists were hand searched.
Results
Computerized
database search revealed 37 citations of relevance, 10 of which
fulfilled the inclusion/exclusion criteria. From the aforementioned, 8
articles were acquired (2 authors were contacted but did not respond) as
well as assessed with AHRQ, QUADAS, and STARD evaluation tools.
Finally, 6 papers (5 prospective and 1 retrospective) were included in
the systematic review.
Conclusions
MRI
with intravenous (IV) contrast administration provides the highest
post-test probability of ovarian cancer detection. However, the
preponderant contribution of MRI in adnexal mass evaluation is its
specificity because it provides confident diagnosis of many benign
adnexal lesions.
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