engleski

Assessment of tubo-ovarian abscess using diffusion-weighted magnetic resonance imaging: a literature review

Objective of this review was to summarize and define the efficacy of combining conventional magnetic resonance imaging (MRI) with diffusion- weighted imaging (DWI) in the assessment of tubo- ovarian abscess (TOA) and distinguishing TOA from ovarian neoplasms. The use of DWI has been fairly documented, however limited reports are available on efficacy of combining DWI and MRI (DW-MRI) in the evaluation of patients with TOA. Literature searches of English-language articles were performed in PubMed and Google Scholar. The used keywords included: “Tubo-ovarian abscess”, “Diffusion-weighted magnetic resonance imaging”. Additional studies were noted by reviewing reference lists of found studies. Identified studies revealed that TOA presents on MRI as multilocular, mixed cystic to solid pelvic mass with heterogeneously high signal on T2-weighted and low signal on T1-weighted images. TOAs usually demonstrate high signal intensity on DWI with low apparent diffusion coefficient (ADC) values. Display of the invasion into adjacent organs and tubal dilatation is more frequent in TOA than in ovarian malignancy. The size of TOA is noticeably smaller compared to ovarian malignancy and in addition, neoplasms are not usually associated with dilated fallopian tube. In comparison to other methods (positron emission tomography/computed tomography (PET/CT), CT, MRI), DW-MRI possesses highest sensitivity, specificity, positive predicting value, negative predicting value and accuracy in the assessment of TOA. The addition of DWI, with corresponding ADC values, to conventional MRI improved the overall evaluation of TOA and its distinction from ovarian tumors. Therefore, combination of DWI with MRI in the assessment of TOA should become obligatory.

Diffusion-weighted imaging ; Magnetic resonance imaging ; Tubo-ovarian abscess ; Pelvic inflammatory disease ; Ovarian neoplasms

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