Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2018 May;29(3):e26. doi: 10.3802/jgo.2018.29.e26. Epub 2018 Jan 4.
To retrospectively assess conventional magnetic resonance imaging (MRI) features that differentiate malignant pure mesenchymal uterine tumors (MPMUT); endometrial stromal sarcoma (ESS) and leiomyosarcoma (LMS) from uterine leiomyoma with cystic degeneration (ULCD).
We retrospectively reviewed magnetic resonance (MR) images of 30 patients with ULCD, 18 with ESS, and 15 with LMS, to assess tumor location, margin, T2 signal intensity (SI), speckled appearance, and peripheral band using univariate and multivariate analyses.
ULCD more frequently showed subserosal location (53.3%), well-defined margin (96.7%), and speckled appearance (90.0%) compared with ESS (0%, 33.3%, and 33.3%, respectively) or LMS (20.0%, 33.3%, and 60.0%, respectively). In quantitative T2 SI comparisons, the T2 SI ratio of the main solid tumor portion to gluteus maximus muscle differed significantly among the three groups, with ULCD showing a lower SI ratio (0.62) compared with ESS (2.44) and LMS (1.13). On multivariate analysis, an ill-defined margin (odds ratio [OR]=44.885; p=0.003) and high T2 SI (OR=4.396; p=0.046) were the significant MR differentiators.
An ill-defined tumor margin and high T2 SI ratio of the main solid tumor-to-gluteus maximus muscle were useful MRI features in the differentiation of MPMUT from ULCD.
回顾性评估常规磁共振成像（MRI）特征，以区分恶性单纯间质性子宫肿瘤（MPMUT）；子宫内膜间质肉瘤（ESS）和平滑肌肉瘤（LMS）与囊性变性的平滑肌瘤（ULCD）。
我们回顾性分析了 30 例 ULCD、18 例 ESS 和 15 例 LMS 患者的磁共振（MR）图像，以评估肿瘤位置、边缘、T2 信号强度（SI）、斑点外观和外周带，采用单变量和多变量分析。
与 ESS（0%、33.3%和 33.3%）或 LMS（20.0%、33.3%和 60.0%）相比，ULCD 更常表现为子宫浆膜下位置（53.3%）、清晰的边界（96.7%）和斑点外观（90.0%）。在定量 T2 SI 比较中，三组之间主实质肿瘤部分与臀大肌的 T2 SI 比值差异有统计学意义，ULCD 显示较低的 SI 比值（0.62），与 ESS（2.44）和 LMS（1.13）相比。多变量分析显示，边界不清（比值比[OR]=44.885；p=0.003）和 T2 SI 高（OR=4.396；p=0.046）是有意义的 MRI 鉴别特征。
肿瘤边界不清和主实质肿瘤与臀大肌的 T2 SI 比值高是 MPMUT 与 ULCD 鉴别诊断的有用 MRI 特征。
