Benign ve malign jinekolojik kitlelerde görünen difüzyon katsayısı ölçümlerinin ve manyetik rezonans görüntüleme bulgularının değerlendirilmesi

Yıl 2025, Cilt: 16 Sayı: 2, 377 - 385, 30.06.2025

Büşra Şeker , Gökhan Yılmaz , Nisa Başpinar , Begüm Kurt , Orhan Solak

https://doi.org/10.18663/tjcl.1724174

Öz

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.

Anahtar Kelimeler

Jinekolojik kitleler , difüzyon ağırlıklı görüntüleme , görünen difüzyon katsayısı , malign , servikal kanser

Evaluation of apparent diffusion coefficient measurements and magnetic resonance imaging findings in benign and malignant gynecologic masses

Öz

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.

Anahtar Kelimeler

Gynecologic masses , diffusion-weighted imaging , apparent diffusion coefficient , malignant , cervical cancer

Etik Beyan

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Cumhuriyet University Non-Interventional Clinical Research Ethics Committee (Date: 20.02.2019, Approval No: 2019-02/26).

Kaynakça

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