Evaluation of solid abdominopelvic masses in pediatric patients with diffusion-weighted and contrast-enhanced magnetic resonance imaging

This study aimed; to investigate the ef-fectiveness of quantitative evaluation of diffusion and contrast enhancement features in magnetic resonance imaging of solid malignant and benign abdominopelvic masses seen in the pediatric age group. For this purpose, 49 pediatric patients with solid ab-dominopelvic masses who underwent an MRI examination between June 2015 and September 2022 were included in the study. Of 49 masses, 32 were malignant and 17 were benign. MR images of the patients were evaluated retrospectively by two radio-logist with 4 and 15 years of experience, respectively. The mean age of the patients was 59.7±54 (1-198) months, and the median value was 41 (13.5;93.5) months. Mea-surements were performed by placing ROIs in the areas corresponding to the qualita-tively most enhancing area of the tumor. There was no significant relationship between patient age and gender and lesion character. As the lesion size increased, the probabi-lity of the lesion being malignant was found to be increased significantly (p=0.018). Minimum, mean, maximum and normalized ADC values were significantly lower in malignant masses than in benign masses (p<0.001). According to ROC analyses, data with the highest sensitivity and specificity was the normalized ADC value and was calculated as ≤1,398. The extent to which the lesion enhanced in single-phase exami-nation was not significant in predicting the type of mass, as to be benign or malignant. Of the two malignancies more frequently observed in pediatric patients, no significant difference was found between the data of Wilms tumor and neuroblastoma. In conclu-sion, adding diffusion-weighted images and ADC maps to conventional sequences in the evaluation of abdominopelvic masses seen in the pediatric age group with MRI provides very useful information in detecting the type of mass. Studies with normali-zed ADC data will provide useful information to the literature. Key Words: ADC, DAG, pediatric abdomen, MRI