Abstract/References

The utility of MRI for the preoperative differential diagnosis of uterine sarcoma and leiomyoma: a single-center study

Hiroyuki Yazawa, Riho Yazawa, Kazuki Anjo, Akari Inazuki, Manabu Kikuta

Author information
  • Hiroyuki Yazawa
    Department of Obstetrics and Gynecology, Fukushima Red Cross Hospital
  • Riho Yazawa
    Department of Obstetrics and Gynecology, Fukushima Red Cross Hospital
  • Kazuki Anjo
    Junior Resident, Fukushima Red Cross Hospital
  • Akari Inazuki
    Junior Resident, Fukushima Red Cross Hospital
  • Manabu Kikuta
    Department of Radiology, Fukushima Red Cross Hospital

Abstract

Although uterine sarcoma is a rare disease, its prognosis is extremely poor;thus, it is important to differentiate it from uterine leiomyoma. In this retrospective study, we examined the association between preoperative MRI findings and postoperative pathology results in 170 patients with uterine tumors who underwent preoperative MRI examination at Fukushima Red Cross Hospital. In 4 cases of sarcoma / smooth muscle tumor of unknown malignant potential (STUMP), abnormal findings were found at a high frequency with T1-weighted imaging (T1WI) (75%), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast enhancement (CE) (100%). In cases of ordinary leiomyoma, on the other hand, abnormal findings were less frequent. The rates of high DWI signal intensity for degenerated and cellular leiomyoma were 31% and 64%, respectively, and the CE-positive rates were 31% and 57%, respectively. Apparent Diffusion Coefficient (ADC) values appeared to be useful in differentiating degenerated leiomyoma from sarcoma. The relatively characteristic findings of uterine sarcoma on MRI images may overlap with those of degenerated leiomyoma and cellular leiomyoma, making it difficult to diagnose sarcoma on imaging alone. However, findings that distinguish sarcoma from ordinary, degenerated, and cellular leiomyoma cases are worthy of attention, to avoid overlooking sarcoma.

The content of research paper

References

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Figures

MRI images and pathological specimens of four medical cases, showcasing various tumors and conditions.
Images of MRI scans and pathological specimens related to two cases of cellular leiomyoma in patients aged 49 and 50.
Medical imaging comparison of two cases: myxoid degenerated myoma and hydropic leiomyoma, with MRI scans and pathology images.
Box plot comparing ADCV values of ordinary, degenerated, cellular leiomyoma, and sarcoma/STUMP.
Table displaying the number of cases and results of various surgical procedures, including hysterectomy and myomectomy statistics.
Table displaying postoperative pathological diagnoses, including various types of leiomyomas and other tumors.
Table displaying MRI findings, tumor markers, and age by postoperative pathology for various types of leiomyomas.
Table displaying details of cases with intraoperative rapid pathology performed, including various pathologies and their respective surgery counts and diagnosis rates.

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