Type:
Educational Exhibit
Keywords:
Pelvis, Oncology, MR, MR-Diffusion/Perfusion, MR-Functional imaging, Education, Diagnostic procedure, eLearning, Pathology, Cancer
Authors:
G. Levy1, S. Taieb2; 1Nice/FR, 2Lille/FR
DOI:
10.1594/ecr2018/C-3205
Conclusion
A single uterine tumor discovered after 45 years must remind one of sarcoma,
without forgetting the frequent degenerative modifications in ordinary myoma that modify its MRI signal (specially T2).
Frequency argument : 2 leiomyosarcomas per 1000 uterine myomas.
Pelvic MRI in myomas is indicated for mapping of a large polymyomatous uterus / before myomectomy or if atypical myoma in ultrasound or increase in size in post menopause.
Full pelvic MRI protocol is justified if "atypical" myoma in pre-therapeutic management,
associating T2-weighted images correlated with DWI (b1000 hyperintensity with restricted ADC) and perfusion : MRI diagnostic accuracy > 90%.
Table 6
Surgical consequences : fertility in young woman in case of radical hysterectomy for leiomyoma and overall survival in case of "failed" sarcoma with tumoral morcellation.