CT and MRI features of endometrial stromal sarcomas / 中国介入影像与治疗学

ABSTRACT

Objective To observe CT and MRI features of endometrial stromal sarcoma (ESS). Methods: Plain and enhanced imaging data, including CT (n=5) and MRI (n=6) of 11 patients with ESS confirmed by postoperative pathology were analyzed retrospectively. Results: There were 9 cases of singe low-grade ESS and 2 cases of single undifferentiated sarcoma. The lesions located in the uterine cavity in 7 cases, in the myometrium in 4 cases, manifested as circular masses in 8 cases and as irregular masses in 3 cases. The mean maximum diameter of lesions was (9.18±1.36)cm. The boundaries of lesions were clear in 4 cases and unclear in 7 cases. Based on CT and MRI findings, there were 4 patients with solid masses, 6 patients with solid-cystic masses and 1 case with cystic mass. Solid component of lesions manifested as iso- or hypo-attenuation compared with myometrium on plain CT images in 5 patients, including 4 cases with nonuniform density lesions and 1 case with uniform density lesion. MRI showed signal reducing on ADC images in 6 patients. Among them, lesions in 5 cases manifested as iso- or hypo-signal on T1WI, hyper-signal or slightly high signal on T2WI, and slightly high signal on DWI, lesion in another case (cystic mass) manifested as hyper-signal on T1WI, high signal on T2WI and high signal in central area of lesion on DWI. Incremental and continuous enhancement were found in 10 cases, while no enhancement was found in the rest one case (cystic mass). Cystic and necrosis changes were found in 8 cases, and invasions of deep layer myometrium were found in 6 cases. Some of the patients had complications, including adenomyosis in 2 cases, uterine fibroid in 5 cases, pelvic effusion in 5 cases, intrauterine hemorrhage in 1 case and salpingian dropsy in 2 cases. Conclusion: ESS has characteristic CT and MRI findings, which can provide useful references for diagnosis.