Magnetic resonance imaging features of mesonephric-like adenocarcinoma of the uterine corpus in comparison with endometrial endometrioid carcinoma: Multi-institutional study

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-27 DOI:10.1016/j.ejrad.2025.112260

Saki Yamamoto , Mitsuru Matsuki , Sota Masuoka , Tomohiro Kikuchi , Hiroyuki Fujii , Atsushi Kihara , Naoki Sano , Noriyoshi Fukushima , Hiroyuki Fujiwara , Hiroki Kato , Yuki Himoto , Hideyuki Fukui , Takahiro Tsuboyama , Yoshiko Ueno , Shinya Fujii , Kaori Yamada , Harushi Mori

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Abstract

Purpose

To examine magnetic resonance imaging (MRI) features of mesonephric-like adenocarcinoma (MLA) of the uterine corpus.

Method

MRI features of 19 patients with pathologically proven MLA of the uterine corpus were retrospectively compared with those of 95 patients with endometrial endometrioid carcinoma (EEC).

Results

Most patients with MLA were postmenopausal. Advanced FIGO stages were more common in the MLA than in the EEC group (63.2 % vs. 18.9 %, p < 0.001). On MRI, endophytic growth into the myometrium were more frequent in the MLA than in the EEC group (68.4 % vs. 14.7 %, p = 0.005). The median maximum tumor diameter in the MLA group (52.4 mm) tended to be larger than that in the EEC group (38.9 mm), although the difference was not statistically significant (p = 0.374). The tumor-to-muscle signal intensity ratio (SIR) on fat-suppressed gadolinium-enhanced T1-weighted gradient-echo imaging was higher in the MLA group than in the EEC group. (1.67 vs. 1.36, p = 0.002). The SIR on diffusion-weighted imaging (DWI) was comparable between the two groups (8.35 vs. 6.72, p = 0.330). The apparent diffusion coefficient value was lower in the MLA than in the EEC group (0.69 10^-3 mm²/s vs. 0.76 × 10^-3 mm²/s, p = 0.003). Coexisting adenomyosis was more frequent in the MLA than in the EEC group (52.6 % vs. 21.1 %, p = 0.034). The concordance rate between MRI and pathology for adenomyosis coexistence was 84.2 % for MLA, 87.4 % for EEC, and 86.8 % overall. MLA of the uterine corpus was identified in two patients, characterized by development independent of and discontinuous from the endometrium, whereas EEC in all patients demonstrated continuity with the endometrium.

Conclusions

MRI of MLA of the uterine corpus typically demonstrates large, diffuse, and endophytic growth into the myometrium, with strong contrast enhancement and more restricted diffusion compared to EEC, with coexisting adenomyosis present in over 50% of patients. Therefore, postmenopausal women with adenomyosis should be carefully evaluated for MLA on MRI, particularly using DWI.

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子宫体中肾样腺癌与子宫内膜样癌的磁共振成像特征：多机构研究

目的探讨子宫中肾样腺癌（MLA）的磁共振成像（MRI）特征。方法回顾性比较19例经病理证实的子宫肌体MLA与95例子宫内膜样癌（EEC）的mri表现。结果MLA患者多发生在绝经后。晚期FIGO分期在MLA组比EEC组更常见(63.2%比18.9%,p <；0.001)。在MRI上，MLA组的肌层内生生长比EEC组更频繁（68.4%比14.7%,p = 0.005）。MLA组中位最大肿瘤直径（52.4 mm）有大于EEC组（38.9 mm）的趋势，但差异无统计学意义（p = 0.374）。脂肪抑制钆增强t1加权梯度回波成像的肿瘤与肌肉信号强度比（SIR）在MLA组高于EEC组。（1.67 vs. 1.36, p = 0.002）。两组间弥散加权成像（DWI） SIR具有可比性（8.35 vs. 6.72, p = 0.330）。MLA组的表观扩散系数值低于EEC组（0.69 10-3 mm2/s vs. 0.76 × 10-3 mm2/s, p = 0.003）。合并子宫腺肌症在MLA组的发生率高于EEC组（52.6%比21.1%,p = 0.034）。MRI与病理对子宫腺肌症共存的符合率MLA为84.2%，EEC为87.4%，整体为86.8%。2例患者发现子宫体MLA，其特点是独立于子宫内膜而不连续，而所有患者的EEC均表现出与子宫内膜的连续性。结论子宫体MLA的smri典型表现为子宫肌层内巨大的弥漫性内生生长，与EEC相比，对比增强明显，扩散受限，超过50%的患者存在共存的子宫腺肌症。因此，绝经后患有子宫腺肌症的妇女应仔细评估MRI上的MLA，特别是使用DWI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.