Preliminary Investigation into Ultrasound and MRI Presentation of Large-Cell Neuroendocrine Carcinomas of the Uterine Cervix

Abstract

Objective: The aim of this study was to analyze the ultrasound and MRI features of eight patients with cervical large-cell neuroendocrine carcinoma to improve awareness of this disease among sonographers, radiologists, and clinicians.Methods: Clinical data for eight patients with cervical large-cell neuroendocrine carcinoma confirmed by pathology at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between February 2018 and April 2021 were retrospectively analyzed according to clinical, conventional ultrasound, contrast-enhanced ultrasound, and MRI characteristics.Results: Conventional ultrasound examination of the cervical large-cell neuroendocrine carcinoma lesions in the eight patients revealed two features: (1) irregular hypoechoic areas in the muscular layer, with slightly hyperechoic inlay streaks, and poorly delineated lesions, and (2) slightly abundant blood flow distribution in the lesions. The contrast-enhanced ultrasound showed a “fast-in and fast-out” mode; after subsidence, a “fence-like” change was observed, and the enhancement range was significantly greater than the range of two-dimensional ultrasound. In MRI, T1WI showed a low signal or isosignal; T2WI showed a high signal; DWI showed a high signal and low ADC value; and most of the enhanced MRI showed inhomogeneous hyperenhancement.Conclusion: Conventional ultrasound, contrast-enhanced ultrasound and MRI are complementary methods that provide additional imaging information for the diagnosis of cervical large-cell neuroendocrine carcinoma.