MR imaging of endometrial stromal sarcoma: correlation with pathologic findings.

Koyama, Takashi; Togashi, Kaori; Konishi, Ikuo; Kobayashi, Hideshi; Ueda, Hitoshi; Kataoka, Milliam L.; Itoh, Tomoo; Higuchi, T; Fujii, Shingo; Konishi, Junji

doi:10.2214/ajr.173.3.10470920

Cited by 109 publications

(81 citation statements)

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“…9,21 Our study suggested that tumor location might help in predicting the histological type of uterine sarcoma, but because histological type cannot be distinguished on the basis of tumor size, necrosis, or hemorrhagic change alone, a detailed assessment of MR imaging is needed.…”

Section: Discussionmentioning

confidence: 93%

Assessment of MR Imaging as a Tool to Differentiate between the Major Histological Types of Uterine Sarcomas

et al. 2015

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Objectives: We retrospectively compared and quantified magnetic resonance (MR) images to distinguish major histological types of uterine sarcomas and malignant and benign tumors.Methods: MR images were obtained from patients who underwent preoperative examinations. We compared 25 pathologically confirmed uterine sarcomas (8 leiomyosarcomas, 11 carcinosarcomas, 6 endometrial stromal sarcomas) with 25 uterine leiomyomas. MR findings included tumor size, location, contour, signal intensity (SI), and contrast enhancement. Analysis focused on the contrast ratio (CR) of SI in T 2 -weighted images for the areas of lowest, highest, and main SI of each tumor as well as the contrast-enhanced ratio (CER) for the main solid part of each tumor in contrast-enhanced T 1 -weighted images. We evaluated diffusion-weighted (DW) images and apparent diffusion coefficient (ADC) values in 18 tumors (4 sarcomas, 14 leiomyomas).Results: Uterine sarcomas and leiomyomas differed significantly in tumor location, contour, hemorrhaging, necrotic and cystic components, CR for the area of lowest SI (P < 0.05), CR for the area of main SI (P < 0.01), and CER (P < 0.05). Leiomyosarcomas were larger than carcinosarcomas or endometrial stromal sarcomas, and the CR for the area of lowest SI of leiomyosarcomas (P < 0.05) was significantly lower. The CER for endometrial stromal sarcomas (P < 0.05) showed the most homogeneous enhancement. Hemorrhagic or necrotic and cystic components were found more often in larger tumors, although there was no significant difference in their occurrence between sarcoma types. All uterine sarcomas showed high intensity on DW images. The ADC values were lower of uterine sarcomas than leiomyomas, although the difference was not statistically significant.Conclusion: Quantitative assessment using the CR or CER was useful for distinguishing benign and malignant uterine tumors as well as major histological types of uterine sarcomas.

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Section: Discussionmentioning

confidence: 93%

Assessment of MR Imaging as a Tool to Differentiate between the Major Histological Types of Uterine Sarcomas

et al. 2015

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“…On T2-WI MRI, uterine sarcomas often manifest intermediate to high signal intensity ( Fig. 4) [38][39][40][41][42]. Although MRI usually yields a specific diagnosis of the much more common benign leiomyomas, they are occasionally associated with various types of degeneration or cellular histologic subtypes and this may result in increased signal intensity on T2-WI (Fig.…”

Section: Uterine Cervixmentioning

confidence: 99%

Role of diffusion-weighted imaging in the diagnosis of gynecological diseases

et al. 2008

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Recent technical advances in diffusion-weighted imaging (DWI) greatly enhanced the clinical value of magnetic resonance imaging (MRI) of the body. DWI can provide excellent tissue contrast based on molecular diffusion and may be able to demonstrate malignant tumors. Quantitative measurement of the apparent diffusion coefficient (ADC) may be valuable in distinguishing between malignant and benign lesions. We reviewed DWI and conventional MRI of the female pelvis to study the utility of DWI in patients with gynecological diseases. Although the ADC can help to differentiate between normal and cancerous tissue in the uterine cervix and endometrium, its utility may be limited by the large overlap of the uterine myometrium and ovaries. On the other hand, the ADC may be useful for monitoring the therapeutic outcome after uterine arterial embolizati (UAE), chemotherapy and/or radiation therapy. In patients with ovarian cancer, DWI demonstrates high intensity not only at the primary cancer site but also in disseminated peritoneal implants. When added to conventional MRI findings, DWI and ADC values provide additional information and DWI may play an important role in the diagnosis of patients with gynecological diseases.

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“…Given its invasive appearance, a sarcoma such as endometrial stromal tumor was considered because these tumors tend to have a predominant myometrial component with little endometrial involvement. The low-grade tumors tend to occur in a younger age group (mean age, 39 years) (14). Leiomyosarcomas can exhibit areas of hemorrhage, but not in multiple well-defined locules, as seen in this case.…”

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confidence: 57%

Uterus‐like mass: MRI appearance of a very rare entity

Menn

Qin

Fedoriw

et al. 2007

Magnetic Resonance Imaging

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We describe a 37-year-old patient who presented with right lower quadrant pain and intermenstrual bleeding. MRI demonstrated a 5 ϫ 5 cm lobulated mass centered in the right uterine wall interpreted as suspicious for malignancy. A total hysterectomy was performed, and the gross and histologic features were consistent with the diagnosis of a uterus-like mass. Uterus-like mass is a benign entity that can be found in a variety of organs, and is characterized by endometrium surrounded by smooth muscle. It is an extremely rare lesion with only approximately 15 cases reported in the current literature. There is a lack of imaging literature on this entity, which is primarily described in the pathology literature. Its histogenesis is uncertain, but is theorized to be metaplastic change, congenital anomaly, and/or heterotopia. However, given the MRI appearance in this case, we feel that uterus-like mass could be prospectively diagnosed or listed in a differential diagnosis.

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MR imaging of endometrial stromal sarcoma: correlation with pathologic findings.

Cited by 109 publications

References 0 publications

Assessment of MR Imaging as a Tool to Differentiate between the Major Histological Types of Uterine Sarcomas

Assessment of MR Imaging as a Tool to Differentiate between the Major Histological Types of Uterine Sarcomas

Role of diffusion-weighted imaging in the diagnosis of gynecological diseases

Uterus‐like mass: MRI appearance of a very rare entity

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