The shading sign: is it exclusive of endometriomas?

João Lopes Dias, Filipe Veloso Gomes, Rita Lucas, Teresa Margarida Cunha

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Objectives: To investigate if the shading sign is an exclusive MRI feature of endometriomas or endometrioid tumors, and to analyze its different patterns. Methods: Three hundred and fourty six women with adnexal masses who underwent 1.5/3-T MRI were included in this retrospective, board-approved study. The shading sign was found in 56 patients, but five cases were excluded due to lack of imaging follow-up or histological correlation. The final sample included 51 women. The type of tumor and the pattern of shading were recorded for each case. Results: Thirty endometriomas and five endometrioid carcinomas were found. The remaining 16 cases corresponded to other benign and malignant tumors. The overall sensitivity, specificity, positive predictive value, and negative predictive value were 73%, 93%, 59%, and 96%, respectively. Restricting the analysis to cystic lesions without solid or fat component, sensitivity, specificity, positive predictive value, and negative predictive value were 73%, 96%, 94%, and 80%. Five shading patterns were identified: layering (15.7%), liquid–liquid level (11.8%), homogenous (45.1%), heterogeneous (11.8%), and focal/multifocal shading within a complex mass (19.6%). No significant correlation was found between these patterns and the type of tumor. Conclusions: The shading sign is not exclusive of endometriomas or endometrioid tumors. Homogenous shading was the most prevalent pattern in endometriomas and half of the cases with focal/multifocal shading within a complex mass were endometrioid carcinomas.

Original languageEnglish
Pages (from-to)2566-2572
Number of pages7
JournalAbdominal Imaging
Volume40
Issue number7
DOIs
Publication statusPublished - 29 Oct 2015

Keywords

  • Endometrioid carcinoma
  • Endometrioma
  • Gynecology
  • Imaging
  • Magnetic resonance imaging

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