title: The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas.
abstract: The usefulness of diffusion-weighted (DW) magnetic resonance (MR) imaging for the diagnosis of uterine sarcomas was investigated, as well as whether DW images and quantitative measurement of apparent diffusion coefficient (ADC) values can facilitate differentiating uterine sarcomas from benign leiomyomas. MR images including DW images were obtained in 43 surgically treated patients with 58 myometrial tumors, including seven uterine sarcomas (five leiomyosarcomas and two endometrial stromal sarcomas) and 51 benign leiomyomas (43 ordinary leiomyomas, two cellular leiomyomas and six degenerated leiomyomas). Qualitative analysis of non-enhanced and postcontrast MR images and DW images and quantitative measurement of ADC values were performed for each myometrial tumor. Both uterine sarcomas and cellular leiomyomas exhibited high signal intensity on DW images, whereas ordinary leiomyomas and most degenerated leiomyomas showed low signal intensity. The mean ADC value (10(-3) mm(2)/s) of sarcomas was 1.17 +/- 0.15, which was lower than those of the normal myometrium (1.62 +/- 0.11) and degenerated leiomyomas (1.70 +/- 0.11) without any overlap; however, they were overlapped with those of ordinary leiomyomas and cellular leiomyomas. In addition to morphological features on nonenhanced and postcontrast MR sequences, DW imaging and ADC measurement may have a potential ability to differentiate uterine sarcomas from benign leiomyomas.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tamai
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Saga
authors.forename: Nobuko
authors.initials: N
authors.lastname: Morisawa
authors.forename: Koji
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Mikami
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007889:Leiomyoma / Q000473:pathology*; D008875:Middle Aged; D012509:Sarcoma / Q000473:pathology*; D014594:Uterine Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media