Histology, Morphological Sciences Department, "Iuliu Hațieganu" University of Medicine and Pharmacy; Louis Pasteur street, number 4, Cluj-Napoca, 400349, Cluj, Romania.
Radiology and Imaging Department, County Emergency Hospital, Cluj-Napoca; Clinicilor street, number 3-5, Cluj-Napoca, 400006, Cluj, Romania.
Curr Med Imaging. 2021;17(4):524-531. doi: 10.2174/1573405616999201027211132.
Endometriomas and functional hemorrhagic cysts (FHCs) are a common gynecological encounter.
This study aimed to assess the diagnostic efficiency of magnetic resonance imaging (MRI) using signal intensity measurements in differentiating endometriomas from FHCs.
Forty-six patients who underwent pelvic MRI examinations (endometriomas, n=28; FHCs, n=18) were retrospectively included. The "T2 shading" sign was evaluated subjectively and quantitatively by measuring the T1-T2 signal intensity difference and calculating the percentage of signal decrease between T1 and T2-weighted sequences. The resulted values, along with the measurement of the Apparent Diffusion Coefficient (ADC) and the signal intensity on three diffusion- weighted sequences (DWI) (b, b, and b), were compared between groups by using the Mann-Whitney U test. Also, the receiver operating characteristic analysis was performed for the statistically significant results (P<0.016), and the area under the curve (AUC) was also calculated.
The two quantitative assessment methods showed similar efficiency in detecting endometriomas (P<0.001; sensitivity, 100%; specificity, 81.82%; AUC>0.86), outperforming the classic subjective evaluation of the "T2 shading" sign (sensitivity, 92.86%; specificity, 66.67%). ADC (P=0.52) and DWI measurements (P=0.49, P=0.74, and P=0.78) failed to distinguish between the two entities.
The quantitative analysis and interpretation of the "T2 shading" sign can significantly improve the differential diagnosis between endometriomas and FHCs.
子宫内膜异位囊肿和功能性出血性囊肿（FHC）是常见的妇科疾病。
本研究旨在评估磁共振成像（MRI）信号强度测量在区分子宫内膜异位囊肿和 FHC 方面的诊断效率。
回顾性纳入 46 名接受盆腔 MRI 检查的患者（子宫内膜异位囊肿 28 例，FHC 18 例）。主观和定量评估“T2 阴影”征，通过测量 T1-T2 信号强度差异并计算 T1 和 T2 加权序列之间的信号减少百分比来评估。通过使用 Mann-Whitney U 检验比较组间差异，并进行统计学分析（P<0.016），计算曲线下面积（AUC）。
两种定量评估方法在检测子宫内膜异位囊肿方面具有相似的效率（P<0.001；敏感性 100%，特异性 81.82%，AUC>0.86），优于经典的“T2 阴影”征主观评估（敏感性 92.86%，特异性 66.67%）。ADC（P=0.52）和 DWI 测量（P=0.49，P=0.74，P=0.78）均无法区分这两种病变。
“T2 阴影”征的定量分析和解读可以显著提高子宫内膜异位囊肿和 FHC 之间的鉴别诊断能力。
