tjcl Turkish Journal of Clinics and Laboratory 2149-8296 DNT Ortadoğu Yayıncılık A.Ş. 10.18663/tjcl.1724174 Diagnostic Radiography Tanı Radyografisi Benign ve malign jinekolojik kitlelerde görünen difüzyon katsayısı ölçümlerinin ve manyetik rezonans görüntüleme bulgularının değerlendirilmesi Evaluation of apparent diffusion coefficient measurements and magnetic resonance imaging findings in benign and malignant gynecologic masses https://orcid.org/0000-0001-7766-4276 Şeker Büşra İSTİNYE ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0003-4073-0668 Yılmaz Gökhan İSTİNYE ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0003-4240-6001 Başpinar Nisa CUMHURİYET ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0002-7166-3130 Kurt Begüm CUMHURİYET ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0002-2298-5440 Solak Orhan CUMHURİYET ÜNİVERSİTESİ, TIP FAKÜLTESİ 06 30 2025 16 2 377 385 06 23 2025 06 30 2025 Copyright © 2010, Turkish Journal of Clinics and Laboratory 2010 Turkish Journal of Clinics and Laboratory

Amaç: Bu çalışma, benign ve malign jinekolojik kitleler arasında manyetik rezonans görüntüleme (MRG) bulguları ve çeşitli görünen difüzyon katsayısı (ADC) ölçümleri açısından farkları araştırmayı amaçlamaktadır.Yöntemler: Haziran 2016 ile Kasım 2018 tarihleri arasında incelenen, pelvik kitleye sahip 102 hastanın MRG görüntüleri retrospektif olarak değerlendirildi. Hastalar histopatolojik olarak benign (n=82) veya malign (n=20) şeklinde, lezyon kompozisyonuna (kistik, solid, mikst) ve anatomik lokalizasyona (over, uterus, tüp, serviks) göre sınıflandırıldı. Üç ADC ölçüm yöntemi uygulandı: tüm lezyonu kapsayan geniş ROI'lerden elde edilen diffüz ADC (dADC), her kesitteki en koyu bölgelere yerleştirilen küçük ROI'lerden elde edilen fokal ADC (fADC) ve en düşük üç fADC değerinin ortalaması olarak hesaplanan spesifik ADC (sADC).Bulgular: Lezyon kompozisyonuna göre solid lezyonlar, mikst lezyonlardan daha düşük ADC değerleri gösterdi, ancak her bir lezyon kompozisyonunda benign ve malign kategoriler arasında farklılık gözlenmedi. Over ve uterin kitlelerde, ADC değerleri benign ve malign gruplar arasında anlamlı fark göstermedi. Servikal kitlelerde benign lezyonların ortalama ADC değerleri malign gruba kıyasla daha yüksekti (dADC için 2,4±0,2 ve 1,1±0,3, p=0,002; fADC için 2,3±0,2 ve 0,7±0,1, p=0,001; sADC için 2,2±0,2 ve 0,6±0,02, p=0,001).Sonuç: Farklı ADC ölçüm yöntemleri arasında, özellikle servikal lezyonlarda, fokal ve spesifik ADC değerleri benign ve malign jinekolojik kitleler arasındaki difüzyon farklılıklarını daha açık şekilde yansıtmıştır. ADC değerleri lezyon kompozisyonundan etkilense de her kompozisyon alt grubunda iyi huylu ve kötü huylu lezyonlar benzer değerler gösterdi.

Aim: This study aimed to investigate the differences in magnetic resonance imaging (MRI) findings and various apparent diffusion coefficient (ADC) measurements between benign and malignant gynecologic masses.Methods: MRI images of 102 patients with pelvic masses, examined between June 2016 and November 2018, were retrospectively reviewed. Patients were categorized histopathologically as benign or malignant, by lesion composition (cystic, solid, mixed), and according to anatomical location (ovary, uterus, tube, cervix). Three ADC measurement methods were applied: diffuse ADC (dADC) from large ROIs covering the entire lesion, focal ADC (fADC) from small ROIs placed on the darkest regions of each slice, and specific ADC (sADC) calculated as the mean of the three lowest fADC values.Results: According to lesion composition, solid lesions demonstrated lower ADC values than mixed lesions, yet no differences were observed between benign and malignant categories within each lesion composition. In ovarian and uterine masses, the value of ADCs showed no significant differences between benign and malignant groups. For cervical masses, the mean ADCs were higher in benign masses compared to malignant masses (dADC: 2.4±0.2 vs. 1.1±0.3, p=0.002; fADC : 2.3±0.2 vs. 0.7±0.1, p=0.001; sADC: 2.2±0.2 vs. 0.6±0.02, p=0.001).Conclusion: Among various ADC measurement strategies, focal and specific ADC values more clearly reflected diffusion differences between benign and malignant gynecologic masses, particularly in cervical lesions. ADC values were affected by lesion composition, yet within each composition subgroup, benign and malignant lesions exhibited comparable values.

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