IRM de diffusion dans le pelvis féminin : principes, technique, pièges et artefacts

Fournier, Laure; Bourillon, Camille; Brisa, M.; Rousseau, Caroline; Chamming’s, Foucauld

doi:10.1016/j.femme.2014.11.001

Cited by 2 publications

(9 citation statements)

References 18 publications

(19 reference statements)

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“…Because of its high proportion of collagenous tissue, the normal myometrium-especially the junctional zone-shows low SI at any b value on DWI and discrete low SI on the ADC map. In contrast, the endometrium has relative high protein content and cellularity, typically showing high SI, at any b value, on DWI ( Figure 1 ) and relative low SI on the ADC map ( 4 , 12 , 14 , 16 ) . The myometrium and endometrium differ in terms of their ADC values throughout the menstrual cycle and menopause.…”

Section: Uterusmentioning

confidence: 99%

“…Due to its high cellularity, this type of leiomyoma does not show the classic MRI features on morphological sequences and can show an increased signal on T2W images ( 4 , 6 , 19 , 20 , 23 ) . On DWI, cellular leiomyomas can also display different features, including high SI at high b values ( Figure 2 ) and low SI on the ADC map-behaving like malignant tumors do ( 12 , 20 , 23 ) . In rare cases, a leiomyoma can undergo sarcomatous transformation into a leiomyosarcoma, the most common malignant tumor of the myometrium ( 4 , 6 , 19 , 23 ) .…”

Section: Cellular Leiomyomas Versus Uterine Sarcomasmentioning

confidence: 99%

“…Because DWI is based on T2W images, tissues with a very long T2 relaxation time, such as simple cysts, can show high SI at all b values, including 1000 s/mm 2 . However, the high SI on DWI of such tissues does not indicate "true" restricted diffusion, because the ADC map will also demonstrate high values ( 1 - 7 , 10 , 12 - 14 , 16 ) .…”

Section: Introductionmentioning

confidence: 99%

“…For an accurate DWI analysis, parametric maps of the apparent diffusion coefficient (ADC), based on at least two different b values, are created for each voxel of an image. These ADC maps are independent of magnetic field strength and show the different tissue diffusion properties at different b values, displaying them in gray-scale images ( 1 , 2 , 7 , 12 - 14 ) . Areas with "free" water molecule movement will show high SI on ADC maps and low SI on DWI with high b values, whereas areas with restricted diffusion, such as tumor tissue, will show low ADC values ("darker" images) and high SI at high b values ( 3 , 5 - 7 , 10 , 11 , 14 , 16 ) .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the reduction of signal intensity (SI) in DWI represents the movement of water molecules. The more "freely" water molecules move, the greater will be the signal loss ( 1 , 2 , 7 , 12 , 14 ) . The diffusion gradients applied have different b values, which translate to different strengths.…”

Section: Introductionmentioning

confidence: 99%

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Pitfalls of diffusion-weighted imaging of the female pelvis

Duarte

Dias

Cunha³

2018

Radiol Bras

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Diffusion-weighted imaging (DWI) is widely used in protocols for magnetic resonance imaging (MRI) of the female pelvis. It provides functional and structural information about biological tissues, without the use of ionizing radiation or intravenous administration of contrast medium. High signal intensity on DWI with simultaneous low signal intensity on apparent diffusion coefficient maps is usually associated with malignancy. However, that pattern can also be seen in many benign lesions, a fact that should be recognized by radiologists. Correlating DWI findings with those of conventional (T1- and T2-weighted) MRI sequences and those of contrast-enhanced MRI sequences is mandatory in order to avoid potential pitfalls. The aim of this review article is the description of the most relevant physiological and benign pathological conditions of the female pelvis that can show restricted diffusion on DWI.

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Section: Uterusmentioning

confidence: 99%

Section: Cellular Leiomyomas Versus Uterine Sarcomasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pitfalls of diffusion-weighted imaging of the female pelvis

Duarte

Dias

Cunha³

2018

Radiol Bras

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Diffusion-Weighted MRI in the Genitourinary System

Perrot

Zoua

Glessgen

et al. 2022

JCM

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Diffusion weighted imaging (DWI) constitutes a major functional parameter performed in Magnetic Resonance Imaging (MRI). The DW sequence is performed by acquiring a set of native images described by their b-values, each b-value representing the strength of the diffusion MR gradients specific to that sequence. By fitting the data with models describing the motion of water in tissue, an apparent diffusion coefficient (ADC) map is built and allows the assessment of water mobility inside the tissue. The high cellularity of tumors restricts the water diffusion and decreases the value of ADC within tumors, which makes them appear hypointense on ADC maps. The role of this sequence now largely exceeds its first clinical apparitions in neuroimaging, whereby the method helped diagnose the early phases of cerebral ischemic stroke. The applications extend to whole-body imaging for both neoplastic and non-neoplastic diseases. This review emphasizes the integration of DWI in the genitourinary system imaging by outlining the sequence’s usage in female pelvis, prostate, bladder, penis, testis and kidney MRI. In gynecologic imaging, DWI is an essential sequence for the characterization of cervix tumors and endometrial carcinomas, as well as to differentiate between leiomyosarcoma and benign leiomyoma of the uterus. In ovarian epithelial neoplasms, DWI provides key information for the characterization of solid components in heterogeneous complex ovarian masses. In prostate imaging, DWI became an essential part of multi-parametric Magnetic Resonance Imaging (mpMRI) to detect prostate cancer. The Prostate Imaging–Reporting and Data System (PI-RADS) scoring the probability of significant prostate tumors has significantly contributed to this success. Its contribution has established mpMRI as a mandatory examination for the planning of prostate biopsies and radical prostatectomy. Following a similar approach, DWI was included in multiparametric protocols for the bladder and the testis. In renal imaging, DWI is not able to robustly differentiate between malignant and benign renal tumors but may be helpful to characterize tumor subtypes, including clear-cell and non-clear-cell renal carcinomas or low-fat angiomyolipomas. One of the most promising developments of renal DWI is the estimation of renal fibrosis in chronic kidney disease (CKD) patients. In conclusion, DWI constitutes a major advancement in genitourinary imaging with a central role in decision algorithms in the female pelvis and prostate cancer, now allowing promising applications in renal imaging or in the bladder and testicular mpMRI.

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IRM de diffusion dans le pelvis féminin : principes, technique, pièges et artefacts

Cited by 2 publications

References 18 publications

Pitfalls of diffusion-weighted imaging of the female pelvis

Pitfalls of diffusion-weighted imaging of the female pelvis

Diffusion-Weighted MRI in the Genitourinary System

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