MR IMAGING IN THE EVALUATION OF BENIGN UTERINE MASSES - VALUE OF GADOPENTETATE DIMEGLUMINE-ENHANCED T1-WEIGHTED IMAGES

Forty-six patients with surgically proved disease (115 leiomyomas, 19 cases of adenomyosis, and 14 endometrial polyps) were studied to determine if gadopentetate dimeglumine-enhanced T1-weighted MR images improve the detection and characterization of benign tumors of the uterus. Lesion detection and characterization were assessed separately for each sequence (unenhanced T1-weighted, proton-density-weighted, and T2-weighted and contrast-enhanced T1-weighted images) and for combinations of sequences (unenhanced T1- and T2-weighted images, unenhanced and contrast-enhanced T1-weighted images, and unenhanced T1- and T2-weighted and contrast-enhanced T1-weighted images). In the evaluation of leiomyomas, analysis of all three sequences provided the best detection (92%) and characterization (92%), but the improvement, except when compared with unenhanced T1-weighted images alone, was not statistically significant. The use of contrast medium did not contribute to either tumor detection or characterization. In the evaluation of adenomyosis, T2-weighted images provided significantly better lesion detection and characterization than did either unenhanced or contrast-enhanced T1-weighted images. In the evaluation of endometrial polyps, however, contrast-enhanced T1-weighted images provided significantly better lesion detection and characterization than did unenhanced images. With contrast-enhanced images, the detection rate was 79%, compared with 36% for T2-weighted images and 7% for T1-weighted images. Lesion characterization was the best (73%) when all imaging sequences were analyzed. Our study shows that with conventional spin-echo sequences, the use of contrast-enhanced T1-weighted images does not improve the detection or characterization of uterine leiomyomas or adenomyosis but significantly improves the detection of endometrial polyps.