Abnormal uterine cavity: differential diagnosis with MR imaging

Imaoka, Izumi; Sugimura, Kazuro; Masui, Takayuki; Takehara, Yasuo; Ichijo, K; Naito, Masaaki

doi:10.1016/s0730-725x(99)00097-1

Cited by 32 publications

(16 citation statements)

References 26 publications

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“…Previous reports have demonstrated the advantages of MR imaging in visualizing endometrial lesions and in the differential diagnosis [18][19][20][21][22]. Meanwhile, some of the endometrial cavity lesions cannot be diagnosed via endometrial cytology or endometrial curettage because sampling is difficult to detect [18], and they are incidentally found at the MR examination of ovarian tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Some diseases of the endometrial cavity can be diagnosed via endometrial cytology or endometrial curettage; however, others are difficult to detect, and characteristic imaging findings are helpful in diagnosis [18]. Previous reports have demonstrated the usefulness of MR imaging techniques such as contrast-enhanced dynamic imaging for differentiating abnormalities of the uterine endometrial cavity [18][19][20][21][22], while there are a few studies about the utility of DW imaging for gynecological imaging [10,[23][24][25][26][27][28][29]. In the uterine cervix, ADC measurement potentially enables differentiation between normal and cancerous tissue [10]; however, to the best of our knowledge, no reports have demonstrated the utility of ADC measurement for differential diagnosis in the uterine endometrial cavity lesions.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results

et al. 2007

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Our purpose is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC) measurement in differentiating malignant from benign uterine endometrial cavity lesions. We retrospectively evaluated 25 uterine endometrial cavity lesions in 25 female patients: endometrial carcinoma (n = 11), carcinosarcoma (n = 2), submucosal leiomyoma (n = 8), and endometrial polyp (n = 4). Diffusion-weighted images were performed at 1.5 T with b factors of 0-1,000/mm(2). The region of interest was defined within the tumor on T2-weighted EPI image and then manually copied to an ADC map. Thereby, the ADC value was obtained. We compared ADC values between malignant and benign lesions using Student's t-test. The mean and standard deviation of ADC values (x10(-3) mm(2)/s) were as follows: endometrial carcinoma, 0.98+/-0.21; carcinosarcoma, 0.97+/-0.02; submucosal leiomyoma, 1.37+/-0.28; and endometrial polyp, 1.58+/-0.45. The ADC values differed significantly between malignant (0.98+/-0.19) and benign lesions (1.44+/-0.34) (P < 0.01). We defined malignant tumors as cases with an ADC value less than 1.15 x 10(-3) mm(2)/s for obtaining the highest accuracy. Sensitivity, specificity, and accuracy were 84.6%, 100%, and 92%, respectively. ADC measurement can provide useful information in differentiating malignant from benign uterine endometrial cavity lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results

et al. 2007

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“…Contrast enhanced images demonstrate the tumor as a poorly enhanced lesion compared with myometrium, and depth of invasion is clearly demonstrated (Fig. 6) [5,8]. On dynamic MRI with gadopentetate dimeglumine, the inner muscle layer of the myometrium showed more rapid contrast enhancement effects than the outer muscle layer, even after menopause [9][10][11].…”

Section: Malignant Endometrial Neoplasmsmentioning

confidence: 99%

Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging

et al. 2005

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The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis.

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“…In the study, the morphological features on T2-weighted images (WI) were reported to be helpful in distinguishing most polyps from carcinomas although biopsy was needed for the diagnostic confirmation [2]. Another study tried to differentiate endometrial lesions using T2WI and contrastenhanced (CE) MR imaging [3]. Using the presence of myometrial invasion and less enhancement of the lesion on late CE T1WI than that of the myometrium as diagnostic criteria for malignancy, the authors reported a fairly high sensitivity, specificity, and accuracy of MR imaging [3].…”

Section: Introductionmentioning

confidence: 99%

Differentiation of the various lesions causing an abnormality of the endometrial cavity using MR imaging: emphasis on enhancement patterns on dynamic studies and late contrast-enhanced T1-weighted images

et al. 2006

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The objectives of this study were to determine the usefulness of magnetic resonance (MR) imaging in the differentiation of various lesions causing an abnormality of the endometrial cavity by evaluating the imaging features on dynamic contrast-enhanced study and late contrast-enhanced T1-weighted images (T1WI). Contrast-enhanced MR imaging of 59 pathologically proven lesions that showed an abnormality of the endometrial cavity, including 32 endometrial cancers, five sarcomas, nine hyperplastic polyps, nine submucosal myomas, three hyperplasia, and one adenomyoma, were retrospectively reviewed. The enhancement degree and patterns on dynamic contrast-enhanced study and late contrast-enhanced T1WI were compared among different pathologies. On dynamic contrast-enhanced study, 72% (23/32) of endometrial cancers showed early peak enhancement to be reached within 1 min following intravenous administration of contrast material. On late-contrast-enhanced T1WI, lesions showed weak enhancement with gradual washout. Ninety-five percent (21/22) of benign lesions and 100% (5/5) of sarcomas showed late peak enhancement to be reached in 2-3 min following intravenous administration of contrast material. On late contrast-enhanced T1WI, both of these lesions showed persistent strong enhancement. Different enhancement patterns on dynamic contrast-enhanced MR imaging and late contrast-enhanced T1WI can provide a useful clue in the differentiation of various lesions causing an abnormality of the endometrial cavity.

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Abnormal uterine cavity: differential diagnosis with MR imaging

Cited by 32 publications

References 26 publications

Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results

Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results

Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging

Differentiation of the various lesions causing an abnormality of the endometrial cavity using MR imaging: emphasis on enhancement patterns on dynamic studies and late contrast-enhanced T1-weighted images

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