J Korean Soc Magn Reson Med.  2013 Dec;17(4):326-333. 10.13104/jksmrm.2013.17.4.326.

H1 Magnetic Resonance Spectroscopy of Cystic Ovarian Lesions

• Kang YH
• Kim MY
• Kim KT
• Kim YJ
• Suh CH
• Kim JM
• Hwang SO
• Park S
• Cho JY

• KMID: 2144336
• DOI: http://doi.org/10.13104/jksmrm.2013.17.4.326

Abstract

On H1 MRS (magnetic resonance spectroscopy), malignant tumors show higher concentration of metabolite than benign lesions. Lactate double peak was detected in malignant tumor and endometriosis, and more prominent high concentration was demonstrated in endometriosis. Tuboovarian abscesses and salpingitis do not show prominent peak. Dermoid cysts show high levels of lipid peak. Paratubal cyst and follicular cyst can be showed the lipid peak, however, the concentration of lipid is lower than that of dermoid cyst. H1 MRS of ovarian cystic lesions can give valuable information about the presence of metabolites of ovarian cystic lesions.

Keyword

Ovary; Cyst; Cystic neoplasm; Magnetic resonance spectroscopy (MRS)

MeSH Terms

Abscess
Dermoid Cyst
Endometriosis
Female
Follicular Cyst
Lactic Acid
Magnetic Resonance Spectroscopy*
Ovarian Cysts
Ovary
Parovarian Cyst
Salpingitis
Lactic Acid

Figure

• 

  Fig. 1 MRS of cystic ovarian lesions. a. Benign cystic tumor shows low signal without prominent peak. b. Malignant cystic neoplasm shows small double peak around 1.3 ppm. c. Endometriosis shows high double peak around the 1.3 ppm, and prominent signal peaks than ovarian cystic neoplasm. d. Dermoid cysts show the high fatty peak. e. Follicular cyst shows fatty peak, and relatively low level of fat contents.

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  Fig. 2 53-year-old women with serous cystadenoma (TR=3157 msec, TE=35 msec). a. Axial T2-weighted MR image shows a lesion of homogeneous hyperintense cystic mass without solid component. b. On MRS, there is no detectable peak.

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  Fig. 3 27-year-old women with borderline mucinous tumor (TR=3157 msec, TE=35 msec). a. Axial T2-weighted MR image shows a multilocular cystic lesion. b. On MRS, there is no detectable peak.

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  Fig. 4 69-year-old women with serous cystadenocarcinoma (TR = 3157 msec, TE=35 msec). a. Axial T2-weighted MR image shows a septated cystic mass with thick septa and solid lesion. b. On MRS, double peaks (asterisk) are observed around 1.3 ppm.

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  Fig. 5 44-year-old women with metastatic squamous cell carcinoma (TR=3157 msec, TE=35 msec). a. Axial T2-weighted MR image shows bilateral ovarian solid and cystic masses. b. On MRS of cystic portion of right ovarian mass shows double peaks (asterisk) around 1.3ppm.

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  Fig. 6 31-year-old women with mature cystic teratoma (TR=1500 msec, TE=135 msec). a. Axial T2-weighted MR image shows a hyperintense cystic lesion containing mural nodule. b. On MRS, single high peak of lipid(arrow) is detected about 1.3 ppm.

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  Fig. 7 38-year-old woman with endometriosis (TR=3157 msec, TE=35 msec). a. Coronal T2-weighted MR image shows shading in lesions. b. On MRS, high lipid and lactate peak (asterisk) and glycine peaks (open arrow) are observed.

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  Fig. 8 48-year-old woman with Tubo-ovarian abscess and pelvic inflammatory disease (TR=1500 msec, TE=30 msec). a. Axial T1-weighted MR image shows thick-walled cystic lesion in pelvic cavity. b. On MRS, there is minimal peak (arrow) at 1.3 ppm.

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  Fig. 9 47-year-old woman with salpingitis (TR=1500 msec, TE=30 msec). a. Coronal T2-weighted MR image shows tubular cystic lesions in both adnexa (arrow). b. On MRS, there is no peak (arrow).

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  Fig. 10 37-year-old women with paratubal cyst (TR=1500 msec, TE=35 msec). a. Contrast enhanced axial T1-weighted MR image shows thin-walled, unilocular cystic lesion and uterine adenomyosis. b. On MRS, there is high lipid peak (arrow).

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  Fig. 11 48-year-old women with follicular cyst (TR=3000 msec, TE=35 msec). a. Axial T2-weighted MR image shows thin-walled, unilocular cystic lesion. b. On MRS, there is high lipid peak (arrow).

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