{"title":"子宫腺肉瘤与子宫内膜息肉的鉴别：MRI影像特征。","authors":"Kumi Harada, Yasuhisa Kurata, Yuki Himoto, Aki Kido, Mitsuhiro Kirita, Atsushi Yoshida, Yuka Kuriyama Matsumoto, Junzo Hamanishi, Sachiko Minamiguchi, Hiroaki Ito, Akitoshi Nakashima, Takashi Minamisaka, Sayaka Daido, Kaoru Abiko, Koki Moriyoshi, Kumiko Ando, Shigeki Arizono, Takuya Aoki, Shigeo Hara, Masaki Mandai, Yuji Nakamoto","doi":"10.1007/s00261-025-04905-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to identify MRI features distinguishing uterine adenosarcoma from endometrial polyps and to predict the presence or absence of sarcomatous overgrowth (SO), a pathological finding linked to poor prognosis.</p><p><strong>Methods: </strong>This multicenter retrospective study included 11 cases of uterine adenosarcoma, with 5 showing SO and 6 without, and 20 cases of endometrial polyps measuring 3 cm or greater diameter. Quantitative evaluations (tumor volume, cystic lesion size, diffusion-weighted imaging [DWI] signal ratio, apparent diffusion coefficient [ADC] value, and normalized ADC value) and qualitative evaluations (degree of hemorrhage, signal intensity on T2-weighted imaging and DWI, number of cystic lesions, degree of contrast enhancement, and tumor localization) were performed. The evaluation parameters were compared between uterine adenosarcoma and endometrial polyp groups, and between SO and non-SO subgroups within uterine adenosarcoma.</p><p><strong>Results: </strong>Uterine adenosarcoma had significantly larger tumor volumes (median 192,324 mm³ vs. 15,717 mm³, p < 0.001), larger cystic lesions (median 17.7 mm vs. 6.7 mm, p = 0.0074), and higher DWI signal ratios (median 1.50 vs. 1.08, p = 0.008) along with significantly lower ADC values (median 961.5 × 10<sup>- 6</sup> mm²/s vs. 1222.3 × 10<sup>- 6</sup> mm²/s, p = 0.048) and normalized ADC values (median 0.34 vs. 0.49, p = 0.001) compared to endometrial polyps. Gross hemorrhage (9/11 vs. 1/20, p < 0.001) and high signal intensity on DWI (10/11 vs. 4/20, p < 0.001) were observed more frequently with uterine adenosarcomas. No significant difference was found between uterine adenosarcomas with SO and without SO for any quantitative or qualitative evaluation parameter.</p><p><strong>Conclusions: </strong>This study identified key imaging features of uterine adenosarcoma, including larger tumor volume, larger cystic lesions, gross intratumoral hemorrhage, higher DWI signal intensity, and lower ADC values. These findings can facilitate preoperative differentiation of uterine adenosarcoma from endometrial polyps.</p>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Differentiating uterine adenosarcoma from endometrial polyps: MRI imaging features.\",\"authors\":\"Kumi Harada, Yasuhisa Kurata, Yuki Himoto, Aki Kido, Mitsuhiro Kirita, Atsushi Yoshida, Yuka Kuriyama Matsumoto, Junzo Hamanishi, Sachiko Minamiguchi, Hiroaki Ito, Akitoshi Nakashima, Takashi Minamisaka, Sayaka Daido, Kaoru Abiko, Koki Moriyoshi, Kumiko Ando, Shigeki Arizono, Takuya Aoki, Shigeo Hara, Masaki Mandai, Yuji Nakamoto\",\"doi\":\"10.1007/s00261-025-04905-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study was conducted to identify MRI features distinguishing uterine adenosarcoma from endometrial polyps and to predict the presence or absence of sarcomatous overgrowth (SO), a pathological finding linked to poor prognosis.</p><p><strong>Methods: </strong>This multicenter retrospective study included 11 cases of uterine adenosarcoma, with 5 showing SO and 6 without, and 20 cases of endometrial polyps measuring 3 cm or greater diameter. Quantitative evaluations (tumor volume, cystic lesion size, diffusion-weighted imaging [DWI] signal ratio, apparent diffusion coefficient [ADC] value, and normalized ADC value) and qualitative evaluations (degree of hemorrhage, signal intensity on T2-weighted imaging and DWI, number of cystic lesions, degree of contrast enhancement, and tumor localization) were performed. The evaluation parameters were compared between uterine adenosarcoma and endometrial polyp groups, and between SO and non-SO subgroups within uterine adenosarcoma.</p><p><strong>Results: </strong>Uterine adenosarcoma had significantly larger tumor volumes (median 192,324 mm³ vs. 15,717 mm³, p < 0.001), larger cystic lesions (median 17.7 mm vs. 6.7 mm, p = 0.0074), and higher DWI signal ratios (median 1.50 vs. 1.08, p = 0.008) along with significantly lower ADC values (median 961.5 × 10<sup>- 6</sup> mm²/s vs. 1222.3 × 10<sup>- 6</sup> mm²/s, p = 0.048) and normalized ADC values (median 0.34 vs. 0.49, p = 0.001) compared to endometrial polyps. Gross hemorrhage (9/11 vs. 1/20, p < 0.001) and high signal intensity on DWI (10/11 vs. 4/20, p < 0.001) were observed more frequently with uterine adenosarcomas. No significant difference was found between uterine adenosarcomas with SO and without SO for any quantitative or qualitative evaluation parameter.</p><p><strong>Conclusions: </strong>This study identified key imaging features of uterine adenosarcoma, including larger tumor volume, larger cystic lesions, gross intratumoral hemorrhage, higher DWI signal intensity, and lower ADC values. These findings can facilitate preoperative differentiation of uterine adenosarcoma from endometrial polyps.</p>\",\"PeriodicalId\":7126,\"journal\":{\"name\":\"Abdominal Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Abdominal Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00261-025-04905-z\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Abdominal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00261-025-04905-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在鉴别子宫腺肉瘤与子宫内膜息肉的MRI特征，并预测是否存在肉瘤性过度生长（SO），这是一种与预后不良相关的病理发现。方法：多中心回顾性研究11例子宫腺肉瘤，其中5例表现为SO， 6例未表现为SO， 20例直径大于3cm的子宫内膜息肉。进行定量评价（肿瘤体积、囊性病变大小、弥散加权成像（DWI）信号比、表观弥散系数（ADC）值、归一化ADC值）和定性评价（出血程度、t2加权成像及DWI信号强度、囊性病变数、对比增强程度、肿瘤定位）。比较子宫腺肉瘤组与子宫内膜息肉组、子宫腺肉瘤内SO亚组与非SO亚组的评价参数。结果：与子宫内膜息肉相比，子宫腺肉瘤的肿瘤体积（中位数192,324 mm³vs. 15,717 mm³，p - 6 mm²/s vs. 1222.3 × 10- 6 mm²/s, p = 0.048）和归一化ADC值（中位数0.34 vs. 0.49, p = 0.001）明显更大。结论：本研究确定了子宫腺肉瘤的主要影像学特征，包括肿瘤体积较大、囊性病变较大、大体瘤内出血、DWI信号强度较高、ADC值较低。这些发现有助于术前区分子宫腺肉瘤和子宫内膜息肉。
Differentiating uterine adenosarcoma from endometrial polyps: MRI imaging features.
Objective: This study was conducted to identify MRI features distinguishing uterine adenosarcoma from endometrial polyps and to predict the presence or absence of sarcomatous overgrowth (SO), a pathological finding linked to poor prognosis.
Methods: This multicenter retrospective study included 11 cases of uterine adenosarcoma, with 5 showing SO and 6 without, and 20 cases of endometrial polyps measuring 3 cm or greater diameter. Quantitative evaluations (tumor volume, cystic lesion size, diffusion-weighted imaging [DWI] signal ratio, apparent diffusion coefficient [ADC] value, and normalized ADC value) and qualitative evaluations (degree of hemorrhage, signal intensity on T2-weighted imaging and DWI, number of cystic lesions, degree of contrast enhancement, and tumor localization) were performed. The evaluation parameters were compared between uterine adenosarcoma and endometrial polyp groups, and between SO and non-SO subgroups within uterine adenosarcoma.
Results: Uterine adenosarcoma had significantly larger tumor volumes (median 192,324 mm³ vs. 15,717 mm³, p < 0.001), larger cystic lesions (median 17.7 mm vs. 6.7 mm, p = 0.0074), and higher DWI signal ratios (median 1.50 vs. 1.08, p = 0.008) along with significantly lower ADC values (median 961.5 × 10- 6 mm²/s vs. 1222.3 × 10- 6 mm²/s, p = 0.048) and normalized ADC values (median 0.34 vs. 0.49, p = 0.001) compared to endometrial polyps. Gross hemorrhage (9/11 vs. 1/20, p < 0.001) and high signal intensity on DWI (10/11 vs. 4/20, p < 0.001) were observed more frequently with uterine adenosarcomas. No significant difference was found between uterine adenosarcomas with SO and without SO for any quantitative or qualitative evaluation parameter.
Conclusions: This study identified key imaging features of uterine adenosarcoma, including larger tumor volume, larger cystic lesions, gross intratumoral hemorrhage, higher DWI signal intensity, and lower ADC values. These findings can facilitate preoperative differentiation of uterine adenosarcoma from endometrial polyps.
期刊介绍：
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
Reasons to Publish Your Article in Abdominal Radiology:
· Official journal of the Society of Abdominal Radiology (SAR)
· Published in Cooperation with:
European Society of Gastrointestinal and Abdominal Radiology (ESGAR)
European Society of Urogenital Radiology (ESUR)
Asian Society of Abdominal Radiology (ASAR)
· Efficient handling and Expeditious review
· Author feedback is provided in a mentoring style
· Global readership
· Readers can earn CME credits
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