Adnexal masses: transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure.

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Abstract
PURPOSE: To evaluate the accuracy of transvaginal ultrasound (US) and gadolinium-enhanced magnetic resonance (MR) imaging in the assessment of the intratumoral structure of an adnexal mass. MATERIALS AND METHODS: The population comprised 82 patients with an adnexal mass who underwent both transvaginal US and gadolinium-enhanced MR imaging and had surgical confirmation. The findings from both modalities were compared retrospectively with those of surgery. RESULTS: The sensitivity, specificity, and accuracy were 100%, 98%, and 99% with MR imaging and were 97%, 46%, and 68% with transvaginal US for the identification of solid tissue in the masses. Transvaginal US exhibited many (n = 25) false-positive results, especially in evaluation of lesions filled with blood or fatty tissue and small echogenic excrescences adherent to the wall, such as blood or fatty tissue. CONCLUSION: Both transvaginal US and gadolinium-enhanced MR imaging were highly sensitive in identification of solid components within an adnexal mass. Gadolinium-enhanced MR imaging was specific, whereas transvaginal US was nonspecific.

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