International Journal of Clinical Obstetrics and Gynaecology

Background: Ovarian masses present significant diagnostic challenges, particularly in distinguishing benign and malignant lesions. Accurate differentiation is critical for appropriate treatment planning, as ovarian cancer remains one of the major lethal malignancies among females. Late diagnoses contribute to poor outcomes, highlighting the need for improved detection methods.

Objective: To evaluate the effectiveness of Contrast Enhanced Magnetic Resonance Imaging (CE-MRI) and Diffusion-Weighted Imaging (DWI) in distinguishing benign from malignant ovarian lesions, thereby enhancing diagnostic accuracy.

Methods: This prospective observational study included 34 women presenting with ovarian masses, conducted over 22 months in the Department of Obstetrics and Gynecology, Surgical Oncology and Radiodiagnosis at SKIMS, Srinagar. All participants underwent CE MRI and DWI MRI. Imaging findings were correlated with histopathological/biopsy results. The analysis of data was done with the help of SPSS software (version 25) with p<0.05.

Results: The majority of lesions were cystic (70.6%) on ultrasonography. CE MRI findings were evenly distributed among homogenous enhancement, no enhancement, and peripheral smooth enhancement (32.3% each). DWI showed diffusion restriction in 58.8% of patients, indicating malignancy potential. ORADS and mRADS scores were predominantly in categories 3 and 4. Histopathological analysis confirmed malignancy in 32.4% of cases, closely aligning with radiological findings. A significant correlation was noted between USG findings and both CE MRI and DWI MRI (p=0.011 and p=0.002, respectively).