Gadolinium-enhanced Fat-Suppression MR Imaging of the Female Pelvis

ABSTRACT

PURPOSE: To compare the value of Gd-DTPA enhanced, fat-suppression T1-weighted (Gd-FST1SE) MR images in thediagnosis of female pelvic disorders with that of fast spin-echo T1-weighted(T1FSE) and fast spin-echoT2-weighted(T2FSE) MR images. MATERIALS AND METHODS: Pelvic MR images of 42 women (24 ovarian disorders, 19uterine disorders) were reviewed by two radiologists. Discrimination of normal anatomic structures, identificationof pathologic lesions and recognition of internal structure of the lesions such as solid and cystic portion,papillary nodule, septa and wall were evaluated using a scoring system. The Friedman two-way ANOVA test was usedfor data analysis. RESULT: T2FSE was useful for evaluation of the uterine cervix(T1/T2/Gd, 2.5/3.9/2.8,respectively), junctional zone(1.6/3.1/2.5), endometrium (2.0/3.3/3.0), ovary(1.1/2.1/1.7) and uterine myoma(1.7/2.4/2.1)(P<0.001), but secondary degeneration was best visualized on Gd-FS T1SE. The Gd-FS T1SE ;lymphadenopathy(3.4/1.5/3.7) was better visualised on this modality than on eithor TIFSE or T2FSE. Gd-FS T1SEimages also clearly depicted papillary projection(2.4/3.1/3.8) and the solid component (2.9/3.1/3.5) of ovariancystic neoplasm(P<0.01). The confidence level in the identification of ovarian mass, internal septation andsurrounding wall of cystic neoplasm was not improved on Gd-FS T1SE. CONCLUSION: The Gd-FS T1SE images were usefulfor the evaluation of metastatic lymphadenopathy in uterine cervical malignancy and for identification of thesolid component and papillary projection of ovarian cystic neoplasm.