Isabelle Thomassin-Naggara MD, Presenter: Nothing to Disclose

Marie-Claude Chevrier MD, Abstract Co-Author: Nothing to Disclose

Lamia Jarboui MD, Abstract Co-Author: Nothing to Disclose

Audrey Morel MD, Abstract Co-Author: Nothing to Disclose

Sophie Dechoux, Abstract Co-Author: Nothing to Disclose

Marc J. Bazot MD, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate the accuracy of pelvic magnetic resonance (MR) imaging performed to characterize indeterminate sonographic adnexal masses during pregnancy and to test the accuracy and the reproducibility of the ADNEXMR score in this population.

Institutional ethics committee approved the study and granted a waiver of informed consent. Our study population comprised 31 pregnant women (mean age : 32 (19-42) with a mean gestational age at the diagnosis of 16 weeks (16-26) who underwent MR imaging for characterization of indeterminate adnexal masses in our center. Two radiologists with 1 and 10 years experience retrospectively evaluated MR criteria for characterization of complex adnexal masses and ADNEXMR score was tested using ROC curve analysis and Kappa values. The reference standard was surgical pathology or at least a one-year imaging follow-up.

The population comprised 27 benign and 9 malgnant masses with a mean size of 103 mm (range :20-290). The ADNEXMR score was performant for both readers (AUROCL1/L2=0.942/0.899) with a high reproducibility (κ > 0.91). No malignant masses were missed with an ADNEXMR score higher or equal to 4 for both readers in all the 4 borderline and the 5 invasive malignant tumors. A score ≤ 3 predicted benignity with a sensitivity of 100% and specificity of 85.2% and 74.1% for reader 1 and 2 respectively. More than 50% of benign lesions were rated by both readers with an ADNEXMR score of 2.

During pregnancy, MR imaging is an accurate tool to differentiate benign form malignant adnexal masses without any cancer missed. ADNEXMR score is as accurate and reproducible as in general population. Thus, our study suggests its potential to improve patient management. Larger multicenter prospective validation of the score is warranted.

MR imaging is highly accurate to characterize adnexal masses during pregnancy and may be helpful to determine the risk with the patient to opt for the absence of surgery specifically until childbirth.

Thomassin-Naggara, I, Chevrier, M, Jarboui, L, Morel, A, Dechoux, S, Bazot, M, Adnexal Masses during Pregnancy: MR Imaging Characterization Using ADNEX MR Score.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13014916.html