Among the 12 patients enrolled in our study,
two of them were excluded because the histolgical result was atypical hyperplasia,
which is not detectable on MR images.
Therefore,
10 women in post-menopausal age were included in our study,
with a mean age of 63 yrs (range 50-76).
All the patients underwent surgery: in cases hysteroannessectomy was performed,
in 9 cases hysteroanessectomy with pelvic and lomboaortic nodes dissection was performed; the histological subtypes were endometrioid adenocarcinoma in 8 paients (80%) and clear cell adenocarcinoma in 2 cases (20%).
Histological grade was G1 in 7 patients (70%) and G2 in 3 patients (30%).
Considering pathological classification,
9 cases were classified as pT1a (90%) and 1 (10%) as pT1b.
Both T2weighted-sequences (T2w) an DCE-MR sequences allowed the identification of lesion in all the cases.
On T2w images,
7 lesions were classified as tumors involving less than 50% of the myometrial thickness and 3 lesions involving more than 50% of the myometrial thickness,
with 1 case of FN and 3 cases of FP.
DCE-MRI identified 8 lesions involving less than 50% of myometrium and 2 lesions involving more than 50% of myometrial thickness,
with 1 FP case.
Only in one case,
both T2w and DCE sequences identified,
according with histological results,
nodes metastases.
The diagnostic performance of T2w sequence in assessing myometrial involvement was calculated,
showing values of sensitivity of 0%,
specificity of 67%,
PPV of 0% and NPV of 86%.
The corresponding values of DCE were respectively 100%,
89%,
50% and 100%.
The diagnostic accuracy values were respectively 60% and 90%.
In one case of endometrioid adenocarcinoma poorly differentiated,
both T2w and DCE sequences overestimated myometrial involvement,
and in one case of well differentiated endometrioid adenocarcinoma T2w images were more diagnostic than DWI ones.
Our study has some limits: firstly,
the limited sample and then also the presence of multiple leiomyomas within myometrial thickness of at least 4 patients,
which are the main responsible of the very low sensitivity of T2w sequences.