title: Abnormal uterine cavity: differential diagnosis with MR imaging.
abstract: The objective of the study was to assess the usefulness of magnetic resonance (MR) imaging in distinguishing malignant from benign conditions in patients with an abnormal uterine cavity. Fifty-four patients that were suspected of having abnormal uterine cavities were retrospectively evaluated by using MR imaging. The diagnosis of an abnormal uterine cavity included a thickened endometrium, and/or a endometrial mass, and/or a submucosal mass. Threshold values to classify the uterine cavity as abnormal on sagittal T2-weighted images were >10 mm for premenopausal women and >5 mm for postmenopausal women. Malignancy was diagnosed when lesions invaded the myometrial/junctional zone, and/or lesion enhancement was lower than that of the adjacent myometrium. The results found that histology confirmed 18 malignant and 37 benign lesions. Twelve of 15 endometrial carcinomas and 3 malignant mixed mesodermal tumors (MMMT) were correctly characterized as malignant on enhanced T1-weighted images; whereas 6 of 15 endometrial carcinomas and 3 MMMT were correctly characterized on T2-weighted images. Thirty-four of 37 benign cases were correctly characterized as not malignant on enhanced T1-weighted images. One of 14 submucosal leiomyomas, one endometrial stromal metaplasia, and one of ten pathologically normal endometria were misdiagnosed on enhanced T1-weighted images but were correctly diagnosed on T2-weighted images. The overall sensitivity, specificity, and accuracy for distinguishing malignant from benign central uterine masses were 83%, 92%, and 89% for enhanced T1-weighted image, and 50%, 97%, and 82% for T2-weighted image, respectively. We came to the conclusion that in diagnosing patients with abnormal uterine cavity, MR imaging may help differentiate malignant from benign disorders.
authors.affiliation: Department of Radiology, Shimane Medical University, Izumo, Japan. iizumi@shimane-med.ac.jp
authors.forename: I
authors.initials: I
authors.lastname: Imaoka
authors.forename: K
authors.initials: K
authors.lastname: Sugimura
authors.forename: T
authors.initials: T
authors.lastname: Masui
authors.forename: Y
authors.initials: Y
authors.lastname: Takehara
authors.forename: K
authors.initials: K
authors.lastname: Ichijo
authors.forename: M
authors.initials: M
authors.lastname: Naito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002277:Carcinoma / Q000175:diagnosis* / Q000601:surgery; D003475:Curettage; D003937:Diagnosis, Differential; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008679:Metaplasia; D008875:Middle Aged; D018199:Mixed Tumor, Mesodermal / Q000175:diagnosis* / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014599:Uterus / Q000473:pathology* / Q000601:surgery