الفهرس 
Anatomy of the AdnexaOnly 14 pages are availabe for public view
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Abstract
Background: Determining whether a clinically diagnosed adnexal mass is benign or malignant is frequently not possible until surgical exploration and histologic examination are performed. Consequently, it may not be possible to decide preoperatively whether conservative or radical surgery is appropriate. Areliable method with which to differentiate a benign from a malignant adnexal mass would provide a basis for optimal preoperative planning.
Aim of study: To get judgment for the utilized MRI tools of assessment and to find out whether diffusion weighted imaging is a necessity or luxury in case we need to asses an adnexal mass.
Patient and method: The current study is a prospective analysis that was conducted at Ain Shams university hospital and Damnhour scan center from 2018 to 2019. The study was performed on 22 cases of ovarian tumors. 5 patients presented by abdominal enlargement, 5 were complaining of long standing abdominal pain, 7came with other different complaints; 4 came complaining with frequency of micturition, dysuria, loss of weight and one case accidentally discovered during US examination.
Results: DWI had shown 100 % sensitivity in its individual performance; yet a low specificity which was 78.6 %. Such low specificity value was attributed to the presence of benign masses that have mimicked malignancy on DWI; starting from their misleading signal intensities of restricted diffusion, down to their measured ADC values. These masses were: mature teratomas and tubo-ovarian abscess.
Conclusion: The solo performance of DWI is not an applicable way to discriminate benign from malignant adnexal masses due to its low specificity. According to us, DWI has sensitivity of (100%), but didn’t improve the specificity (78.6%) or the accuracy (86.4%). DWI can help and increase confidence of MRI in assessment or exclude potential malignancy in complex adnexal masses; provided i) inclusion of the conventional MRI data, ii) combined analysis of DWI quantitative and qualitative criteria and iii) awareness of the possible sequence pitfalls