Ando Tomohiro, Kato Hiroki, Furui Tatsuro, Morishige Ken-Ichirou, Goshima Satoshi, Matsuo Masayuki
1 Department of Radiology, Gifu University School of Medicine , Gifu , Japan.
2 Department of Obstetrics and Gynecology, Gifu University School of Medicine , Gifu , Japan.
Br J Radiol. 2018 Apr;91(1084):20170767. doi: 10.1259/bjr.20170767. Epub 2018 Jan 18.
Hyperintense area on T weighted images (T HIA) have been reported as suggestive features of uterine leiomyosarcoma (LMS), but differentiating LMS from leiomyoma (LM) is often difficult. This study aimed to evaluate the differences between uterine LMS and LM demonstrating intratumoral T HIA.
MRI was performed in 509 patients with 1137 uterine smooth muscle tumours [14 LMSs, 5 smooth muscle tumours of uncertain malignant potential , and 1118 LMs] which exceeded 3 cm in diameter. LM with red degeneration and lipoleiomyoma were excluded from the study. We retrospectively reviewed the images and assessed T HIA within tumours. Results T HIAs were observed in 11/14 (78.6%) LMSs, 0/5 (0%) smooth muscle tumours of uncertain malignant potential, and 15/1118 (1.3%) LMs. T HIAs were more homogenous (53 vs 0%, p < 0.01) and more well-demarcated (60 vs 9%, p < 0.05) in LMs than in LMSs. T hypointense rim within T HIA (53 vs 9%, p < 0.05) was more frequently observed in LMs than in LMSs. The occupying rate of T HIA (0.20 ± 0.24 vs 0.42 ± 0.27, p < 0.05) was smaller in LMs than in LMSs. The signal intensity ratio of T HIA (1.83 ± 0.36 vs 1.38 ± 0.23, p < 0.01) was greater in LMs than in LMSs.
T HIA within LM showed more homogeneity, better demarcation, smaller occupying rate, and higher signal intensity than T HIA within LMS. Advances in knowledge: The differences in T HIA within tumours may be useful for differentiating between LMS and LM.
T加权图像上的高信号区（T HIA）已被报道为子宫平滑肌肉瘤（LMS）的提示性特征，但区分LMS与平滑肌瘤（LM）往往很困难。本研究旨在评估子宫LMS与显示瘤内T HIA的LM之间的差异。
对509例患有1137个直径超过3 cm的子宫平滑肌肿瘤[14例LMS、5例恶性潜能不确定的平滑肌肿瘤和1118例LM]的患者进行了MRI检查。研究排除了发生红色变性的LM和脂肪平滑肌瘤。我们回顾性地分析了图像并评估了肿瘤内的T HIA。结果在14例LMS中的11例（78.6%）、5例恶性潜能不确定的平滑肌肿瘤中的0例（0%）以及1118例LM中的15例（1.3%）观察到T HIA。与LMS相比，LM中的T HIA更均匀（53%对0%，p<0.01）且边界更清晰（60%对9%，p<0.05）。与LMS相比，LM中更频繁地观察到T HIA内的T低信号边缘（53%对9%，p<0.05）。LM中T HIA的占有率（0.20±0.24对0.42±0.27，p<0.05）小于LMS。LM中T HIA的信号强度比（1.83±0.36对1.38±0.23，p<0.01）大于LMS。
与LMS内的T HIA相比，LM内的T HIA显示出更高的均匀性、更好的边界、更小的占有率和更高的信号强度。知识进展：肿瘤内T HIA的差异可能有助于区分LMS和LM。
