T2 hyperintense myometrial tumors: can MRI features differentiate leiomyomas from leiomyosarcomas?

PURPOSE: To establish MRI features that help differentiate atypical leiomyomas and leiomyomas with degeneration that show hyperintensity on T2WI from leiomyosarcomas. METHODS AND MATERIALS: This retrospective study evaluated 41 women who performed MRI before undergoing hysterectomy and had histologically proven atypical leiomyomas, leiomyomas with degeneration or leiomyosarcomas (21 leiomyomas; 20 leiomyosarcomas); only patients with T2 hyperintense myometrial tumors were included. The association between MRI features (contours; free pelvic fluid; intra-tumoral hemorrhagic areas, T2 heterogeneity; T2 dark areas; flow voids; restriction on diffusion-weighted images; signal intensity and heterogeneity after contrast administration; unenhanced areas, localization of unenhanced areas; necrosis; cystic areas) and the histology (leiomyoma vs. leiomyosarcoma) were calculated using Fisher's exact test. For those features that showed a significant association, a univariate linear regression was performed. RESULTS: Five MRI features demonstrated a significant correlation with malignant histology: irregular borders (p = 0.03); "T2 dark" areas (p = 0.02); presence of central necrosis (p = 0.01); presence of high signal on b1000 DWI (p < 0.001); ADC value lower than 0.82 × 10-3 mm2/s; hyperenhancement of the tumor relative to the myometrium on post-contrast images (p = 0.02); and type 3 enhancing curve on DCE. Two of these features demonstrated a significant result predicting a malignant histology: lobulated contours and central necrosis [F(3;34) = 8,95; p < 0.001; R2 = 0.506]. CONCLUSION: The presence of lobulated borders, T2 dark areas, necrosis, hyperintensity relative to the myometrium after contrast administration, central necrosis, presence of high signal on b1000 DWI, ADC value lower than 0.82 × 10-3 mm2/s and type 3 enhancing curve on DCE can help distinguish between leiomyoma and leiomyosarcoma. The association of lobulated borders and central necrosis can help predict a malignant histology.

Primary vaginal malignancies: a single oncology centre experience.

Primary vaginal malignancies constitute a rare entity. The aim of this study was to review all primary vaginal malignancies diagnosed in an oncologic referral centre over 11 years. A total of 35 cases were retrospectively analysed, including clinical and MRI features. Squamous cell carcinoma (SCC) was the most frequent histologic subtype (77.1%), followed by adenocarcinoma (14.3%). There was no statistically significant difference for the mean age at diagnosis or for the mean largest diameter of the tumour. Most SCCs (95%) were homogeneous on T2-weighted imaging, while all adenocarcinomas were heterogeneous (p = .0001). Concerning location, both SCCs (59.3%) and adenocarcinomas (80%) occurred more often on the upper third. However, regarding the wall of origin, all adenocarcinomas originated on the anterior vaginal wall (p = .0002), while SCCs (62.5%) had a predisposition for the posterior wall (p = .017). Regarding the history of previous hysterectomy, in the SCC group, 73.3% of patients with previous hysterectomies had cervical dysplasia (p = .018). Impact statement What is already known on this subject? MRI plays an important role in the initial approach of primary vaginal malignancies. In previous studies, it is said that SCCs usually appear homogeneous on T2WI, with the intermediate-high signal, while adenocarcinomas are often homogeneously hyperintense. Regarding location, it is known that SCCs usually arise from the posterior wall of the upper third, while adenocarcinomas often originate on the anterior wall of the proximal third. What do the results of this study add? In this study, we found that all of our cases of adenocarcinomas were heterogeneous on T2WI, with high-signal intensity areas, while SCCs were predominantly homogeneous, and this association was statistically significant. We could also confirm the data in the literature regarding the most common location of these tumours. This study also showed an association between vaginal SCC and a previous hysterectomy with cervical dysplasia. What are the implications of these findings for clinical practice and/or further research? The histologic type of vaginal malignancy has clinical and management impact. Although MRI is usually performed after histologic characterisation, this is not always the case. We think that this study can constitute a starting point to better understand the MRI features of these rare tumours. Although this technique will obviously never preclude histologic characterisation, it may provide some initial hint on the type of tumour and its aggressiveness.

Validación de los métodos analíticos empleados en el estudio del inyectable de fosfato de disopiramida (13 mg/mL) / Validation of analytical methods used in the study of disopyramide phosphate injectable product (13 mg/mL)

Se realizó la validación de un método espectrofotométrico para ser utilizado en el control de la calidad del inyectable fosfato de disopiramida (13 mg/mL), en la que se determinó la absorbancia a 269 nm, y se empleó como disolvente una mezcla de metanol-sulfúrico. También se realizó la validación de una técnica de cromatografía líquida de alta resolución, en la que se utilizó una columna de Lichrosorb RP-8 y como fase móvil una solución de fosfato de sodio monobásico (0,05 mol/L) pH 3:acetonitrilo (73:27 v/v). Ambos métodos resultaron ser lineales, precisos y exactos, en el rango de concentraciones estudiado. Para la técnica de cromatografía líquida de alta resolución se comprobó, además, su especificidad(AU)

Validación de los métodos analíticos empleados en el estudio del inyectable de fosfato de disopiramida (13 mg/mL) / Validation of analytical methods used in the study of disopyramide phosphate injectable product (13 mg/mL)

Se realizó la validación de un método espectrofotométrico para ser utilizado en el control de la calidad del inyectable fosfato de disopiramida (13 mg/mL), en la que se determinó la absorbancia a 269 nm, y se empleó como disolvente una mezcla de metanol-sulfúrico. También se realizó la validación de una técnica de cromatografía líquida de alta resolución, en la que se utilizó una columna de Lichrosorb RP-8 y como fase móvil una solución de fosfato de sodio monobásico (0,05 mol/L) pH 3:acetonitrilo (73:27 v/v). Ambos métodos resultaron ser lineales, precisos y exactos, en el rango de concentraciones estudiado. Para la técnica de cromatografía líquida de alta resolución se comprobó, además, su especificidad