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To evaluate whether perfusion fraction (PF) calculated with diffusion-weighted magnetic resonance imaging (MRI) predicts the presence of blood supply in ovarian masses.PFs of 92 ovarian lesions in 53 patients administered gadolinium were retrospectively calculated with diffusion-weighted images at b-values of 0, 500, and 1000 sec/mm2. PFs were compared between ovarian lesions, except for fat, with (n = 21) or without contrast enhancement (n = 57), using Student's t-test and receiver operating characteristics (ROC) curve analysis. Lesion enhancement rates of contrast-enhanced images at 30 and 180 seconds after gadolinium injection (ER30sec and ER180sec) and PFs were compared using Pearson's correlation coefficient.PFs of the lesions with contrast enhancement were significantly higher than those without contrast enhancement (0.22 ± 0.09 and 0.02 ± 0.08, respectively, P < 0.0001). The ROC curve identified the best cutoff point for PF at 0.135 (95.2% sensitivity and 94.7% specificity) as a predictor of the contrast enhancement effect. The area under the ROC curve was 0.984. PF correlated moderately with ER30sec (0.62, y = 0.13x + 0.04, P < 0.0001) and ER180sec (0.74, y = 0.13x + 0.03, P < 0.0001).PF calculated with diffusion-weighted images can potentially predict blood supply in ovarian masses. J. Magn. Reson. Imaging 2011. © 2011 Wiley Periodicals, Inc.