Can diffusion weighted imaging distinguish between benign and malignant solid or predominantly solid gynecological adnexal masses?

Objective: To determine the benefit of DWI in diagnosis of benign and malignant solid or predominantly solid gynecological adnexal or ovarian masses. Material and Methods: This study is carried out on 23 patients with histologically proven solid or predominantly solid adnexal or ovarian masses out of which 5 cases (21.8%) have benign and 18 cases (78.2%) have malignant neoplasms. Among these 19 cases (82.6%) have unilateral disease and 4 cases (17.4%) have bilateral disease which was metastatic ovarian carcinoma. Result: On DWI, high signal intensity is noted in malignant lesion more frequently than in benign lesion. (P < 0.001) in adnexal lesions, while in ovarian lesions (P = 0.001). The differentiation between benign and malignant adnexal lesions revealed no significant difference in the apparent diffusion coefficient (ADC) value (P = 0.22). Conclusion: DWI is a helpful tool in differentiation between predominantly solid and solid benign and malignant adnexal lesions because there is an increased frequency of higher signal intensity (diffusion restriction) in malignant lesions. (C) 2012 Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B. V. Open access under CC BY-NC-ND license.