Magnetic resonance imaging in the diagnosis of metastatic ovarian lesions

The aim: To analyze and compare the structure, size, and semiotic features of secondary tumors of the ovary (STO) in different primary malignant neoplasms using magnetic resonance imaging.

Materials and methods. The study included 27 women with various primary malignancies who had secondary (metastatic) ovarian lesion (OVA). The study did not include patients with primary ovarian cancer or benign ovarian tumors. The MRI protocol of the pelvic organs corresponded to the recommendations of the European Society of Urogenital Radiology from 2020 (European Society of Urogenital Radiology, ESUR). The statistical indicators were calculated in a computer program for statistical data processing IBM SPSS Statistics 23.

Results. A total of 44 metastatic ovarian tumors (MOT, second ovarian tumors- SOT) were detected in 27 patients. In the analysis of patients with SOT, unilateral ovarian lesion was detected in 10/27 cases (37%); bilateral ovarian lesion was detected in 17/27 cases (63%). At the same time, with a unilateral lesion, a predominant (7/10, 70%) lesion of the left ovary was noted. There were no statistically significant differences in the sign of a single or bilateral lesion in the analyzed groups of SOT (p-value = 0.115). In the SOT subgroups, it was found that the volume of metastatically altered ovaries in gastric (GC), colon (CC) and endometrial (EC) cancers was significantly higher than in breast cancer (BC) and cervical cancer (p < 0.05). At the same time, the largest volume of metastatically altered ovaries is observed in colon cancer (PK) (p < 0.05).

Conclusions. The study analyzed the volumes and structure of the ovaries in patients with secondary tumors of the ovary in various primary nosologies (stomach cancer, colorectal cancer, breast cancer, uterine cancer). The article describes in detail the semiotic MR characteristics, analyzes the sizes of STO in different subgroups, provides illustrative clinical examples, which will improve the diagnosis of ovarian pathologies and which will allow timely initiation of treatment of the underlying disease. 

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