Department of Radiology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie, Paris, France.
Eur Radiol. 2013 Aug;23(8):2306-14. doi: 10.1007/s00330-013-2819-9. Epub 2013 Apr 8.
To retrospectively evaluate the ability of magnetic resonance imaging (MRI) to differentiate malignant from benign myometrial tumours.
Fifty-one women underwent MRI before surgery for evaluation of a solitary myometrial tumour. At histopathology, there were 25 uncertain or malignant mesenchymal tumours and 26 benign leiomyomas. Conventional morphological MRI criteria were recorded in addition to b 1,000 signal intensity and apparent diffusion coefficient (ADC). Odds ratios (OR) were calculated for each criterion. A multivariate analysis was performed to construct an interpretation model.
The significant criteria for prediction of malignancy were high b 1,000 signal intensity (OR = +∞), intermediate T2-weighted signal intensity (OR = +∞), mean ADC (OR = 25.1), patient age (OR = 20.1), intra-tumoral haemorrhage (OR = 21.35), endometrial thickening (OR = 11), T2-weighted signal heterogeneity (OR = 10.2), menopausal status (OR = 9.7), heterogeneous enhancement (OR = 8) and non-myometrial origin on MRI (OR = 4.9). In the recursive partitioning model, using b 1,000 signal intensity, T2 signal intensity, mean ADC, and patient age, the model correctly classified benign and malignant tumours in 47 of the 51 cases (92.4 %).
We have developed an interpretation model usable in routine practice for myometrial tumours discovered at MRI including T2 signal, b 1,000 signal and ADC measurement.
• MRI is widely used to differentiate benign from malignant myometrial tumours. • By combining T2-weighted, b 1,000 and ADC features, MRI is 92.4 % accurate. • DWI may limit misdiagnoses of uterine sarcoma as benign leiomyoma. • Patient age is important when considering a solitary myometrial tumour.
回顾性评估磁共振成像（MRI）鉴别子宫肌层良恶性肿瘤的能力。
51 名女性因单发子宫肌层肿瘤接受 MRI 检查。在组织病理学上，有 25 例不确定或恶性间叶性肿瘤和 26 例良性平滑肌瘤。除了 b 值为 1000 的信号强度和表观扩散系数（ADC）外，还记录了常规形态学 MRI 标准。为每个标准计算了优势比（OR）。进行了多变量分析以构建解释模型。
用于预测恶性肿瘤的显著标准是高 b 值为 1000 的信号强度（OR=+∞）、中等 T2 加权信号强度（OR=+∞）、平均 ADC（OR=25.1）、患者年龄（OR=20.1）、肿瘤内出血（OR=21.35）、子宫内膜增厚（OR=11）、T2 加权信号异质性（OR=10.2）、绝经状态（OR=9.7）、不均匀强化（OR=8）和 MRI 上的非子宫肌层起源（OR=4.9）。在递归分割模型中，使用 b 值为 1000 的信号强度、T2 信号强度、平均 ADC 和患者年龄，该模型正确分类了 51 例中的 47 例（92.4%）良性和恶性肿瘤。
我们已经开发了一种解释模型，可用于包括 T2 信号、b 值为 1000 的信号和 ADC 测量在内的 MRI 发现的子宫肌层肿瘤的常规实践。
MRI 广泛用于鉴别子宫肌层的良恶性肿瘤。
通过结合 T2 加权、b 值为 1000 的信号和 ADC 特征，MRI 的准确率为 92.4%。
DWI 可能会限制将子宫肉瘤误诊为良性平滑肌瘤。
当考虑单发子宫肌层肿瘤时，患者年龄很重要。
