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基于多模态磁共振成像的子宫内膜癌肉瘤诊断中影像学与病理特征的对比分析

Comparative analysis of imaging and pathological features in diagnosis of endometrial carcinosarcoma based on multimodal MRI.

作者信息

Lan Jin-Ying, Yang Jin-Han, Liang Yuan-Hui, Lin An-Yuan, Liao Jin-Yuan

机构信息

Department of Radiology, Guiping People's Hospital, No. 7 Renmin West Road, Guiping, Guigang, 537200, China.

Department of Pathology, Guiping People's Hospital, No. 7 Renmin West Road, Guiping, Guigang, 537200, Guangxi, China.

出版信息

Arch Gynecol Obstet. 2025 Jan;311(1):159-161. doi: 10.1007/s00404-024-07817-3. Epub 2025 Jan 11.

DOI:10.1007/s00404-024-07817-3
PMID:39797941
Abstract

PURPOSE

This case report aims to present a rare case of endometrial carcinosarcoma, a highly malignant tumor with a poor prognosis. The primary objective is to describe this unique case's clinical presentation, multimodal magnetic resonance imaging (MRI) features, typical histopathological characteristics and surgical treatment.

METHODS

A detailed analysis of the patient's medical history, preoperative imaging evaluation, and treatment approach was conducted. This case report includes high-resolution images and figures, showcasing MRI scans, surgical treatment, and histopathology slides related to the case.

RESULTS

The case report outlines imaging findings of a rare case of endometrial carcinosarcoma. Multimodal imaging such as T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) and multi-b-value diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) scanning could accurately identify the histopathological features of the case. Surgical resection is the best treatment, and preoperative imaging evaluation should be particularly important.

CONCLUSION

This case report highlights endometrial carcinosarcoma's rarity and diagnostic challenges. Multimodal MRI has significant value in diagnosing endometrial carcinosarcoma. This technology not only improves the sensitivity, specificity, and accuracy of diagnosis, but also helps to more accurately evaluate the staging and grading of tumors. By comparing imaging features and pathological results, studies have found that multimodal MRI can clearly show the anatomical structure, pathological nature, and extent of the tumor, with a high degree of consistency with the pathological diagnosis. In particular, when differentiating endometrial carcinosarcoma from low-risk endometrial cancer, multimodal MRI combined with serum carbohydrate antigen 125 (CA125) and E-box binding zinc finger protein 1 (ZEB1) detection can further improve the sensitivity and specificity of differential diagnosis. In addition, research has found that the ADC value of the tumor tissue in different pathological grades is related to the multimodal MRI, which helps to better understand the biological behavior and prognosis of the tumor. In summary, multimodal MRI is an effective diagnostic tool that can provide important evidence for the precise diagnosis and treatment of endometrial carcinosarcoma.

摘要

目的

本病例报告旨在呈现一例罕见的子宫内膜癌肉瘤病例,这是一种预后较差的高度恶性肿瘤。主要目的是描述该独特病例的临床表现、多模态磁共振成像(MRI)特征、典型组织病理学特征及手术治疗情况。

方法

对患者的病史、术前影像学评估及治疗方法进行了详细分析。本病例报告包括高分辨率图像和图表,展示了与该病例相关的MRI扫描、手术治疗及组织病理学切片。

结果

该病例报告概述了一例罕见的子宫内膜癌肉瘤的影像学表现。多模态成像,如T1加权成像(T1WI)、T2加权成像(T2WI)及多b值扩散加权成像(DWI)、表观扩散系数(ADC)和动态对比增强(DCE)扫描能够准确识别该病例的组织病理学特征。手术切除是最佳治疗方法,术前影像学评估尤为重要。

结论

本病例报告突出了子宫内膜癌肉瘤的罕见性及诊断挑战。多模态MRI在诊断子宫内膜癌肉瘤方面具有重要价值。该技术不仅提高了诊断的敏感性、特异性和准确性,还有助于更准确地评估肿瘤的分期和分级。通过比较影像学特征与病理结果,研究发现多模态MRI能够清晰显示肿瘤的解剖结构、病理性质及范围,并与病理诊断具有高度一致性。特别是在鉴别子宫内膜癌肉瘤与低风险子宫内膜癌时,多模态MRI联合血清糖类抗原125(CA125)及E盒结合锌指蛋白1(ZEB1)检测可进一步提高鉴别诊断的敏感性和特异性。此外,研究发现不同病理分级的肿瘤组织ADC值与多模态MRI相关,这有助于更好地了解肿瘤的生物学行为和预后。总之,多模态MRI是一种有效的诊断工具,可为子宫内膜癌肉瘤的精确诊断和治疗提供重要依据。

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本文引用的文献

1
Endometrial carcinosarcoma.子宫内膜癌肉瘤
Int J Gynecol Cancer. 2023 Feb 6;33(2):147-174. doi: 10.1136/ijgc-2022-004073.
2
Uterine carcinosarcoma: A 10-year single institution experience.子宫癌肉瘤:10 年单机构经验。
PLoS One. 2022 Jul 21;17(7):e0271526. doi: 10.1371/journal.pone.0271526. eCollection 2022.
3
Endometrial carcinosarcoma with melanocytic differentiation.伴有黑素细胞分化的子宫内膜癌肉瘤
Pathol Int. 2022 Jul;72(7):382-384. doi: 10.1111/pin.13233. Epub 2022 May 18.
4
Uterine carcinosarcoma: An overview.子宫癌肉瘤:概述。
Crit Rev Oncol Hematol. 2021 Jul;163:103369. doi: 10.1016/j.critrevonc.2021.103369. Epub 2021 May 27.
5
Uterine carcinosarcoma: Contemporary clinical summary, molecular updates, and future research opportunity.子宫癌肉瘤:当代临床总结、分子学新进展及未来研究机遇
Gynecol Oncol. 2021 Feb;160(2):586-601. doi: 10.1016/j.ygyno.2020.10.043. Epub 2020 Nov 9.