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Multiparametric magnetic resonance imaging of endometrial polypoid lesions

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Abstract

Endometrial polypoid lesions encompass various conditions from physiologic changes to benign or malignant disease. Differentiating between the various causes of endometrial polypoid lesions remains difficult by transvaginal sonography. Magnetic resonance imaging (MRI) can provide valuable information regarding endometrial polypoid lesions in situations where it is difficult to obtain histologic samples. Multiparametric MRI including T2-weighted images, T1-weighted fat-saturation contrast-enhanced images, and diffusion-weighted images may be helpful for differentiating the various endometrial polypoid lesions and establishing specific diagnoses and appropriate treatment.

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References

  1. Pujani M, Hassan MJ, Jetley S, Jairajpuri ZS, Khan S, Rana S, Nigam A (2018) A critical appraisal of the spectrum of polypoidal lesions of uterus: A pathologists’ perspective. Al Ameen J Med Sci 11 (1):35-41s

    Google Scholar 

  2. Park BK, Kim B, Park JM, Ryu JA, Kim MS, Bae DS, Ahn GH (2006) Differentiation of the various lesions causing an abnormality of the endometrial cavity using MR imaging: emphasis on enhancement patterns on dynamic studies and late contrast-enhanced T1-weighted images. Eur Radiol 16 (7):1591-1598 https://doi.org/10.1007/s00330-005-0085-1

    Article  PubMed  Google Scholar 

  3. Yang T, Pandya A, Marcal L, Bude RO, Platt JF, Bedi DG, Elsayes KM (2013) Sonohysterography: Principles, technique and role in diagnosis of endometrial pathology. World J Radiol 5 (3):81-87. https://doi.org/10.4329/wjr.v5.i3.81

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ben-Baruch G, Seidman DS, Schiff E, Moran O, Menczer J (1994) Outpatient endometrial sampling with the Pipelle curette. Gynecol Obstet Invest 37 (4):260-262. https://doi.org/10.1159/000292573

    Article  CAS  PubMed  Google Scholar 

  5. Hase S, Mitsumori A, Inai R, Takemoto M, Matsubara S, Akamatsu N, Fujisawa M, Joja I, Sato S, Kanazawa S (2012) Endometrial polyps: MR imaging features. Acta Med Okayama 66 (6):475-485. https://doi.org/10.18926/amo/49044

  6. Bakir B, Sanli S, Bakir VL, Ayas S, Yildiz SO, Iyibozkurt AC, Kartal MG, Yavuz E (2017) Role of diffusion weighted MRI in the differential diagnosis of endometrial cancer, polyp, hyperplasia, and physiological thickening. Clin Imaging 41:86-94. https://doi.org/10.1016/j.clinimag.2016.10.016

    Article  PubMed  Google Scholar 

  7. Kierans AS, Bennett GL, Haghighi M, Rosenkrantz AB (2014) Utility of conventional and diffusion-weighted MRI features in distinguishing benign from malignant endometrial lesions. Eur J Radiol 83 (4):726-732. https://doi.org/10.1016/j.ejrad.2013.11.030

    Article  PubMed  Google Scholar 

  8. Whittaker CS, Coady A, Culver L, Rustin G, Padwick M, Padhani AR (2009) Diffusion-weighted MR imaging of female pelvic tumors: a pictorial review. Radiographics 29 (3):759-774; discussion 774-758. https://doi.org/10.1148/rg.293085130

  9. Silverberg SG, Kurman RJ (1992) Tumors of the uterine corpus and gestational trophoblastic disease. In: Rosai J, Aovin L (eds) Atlas of tumor pathology, vol 3. Armed Forces Institute of Pathology, Washington, D.C., pp 113-151

    Google Scholar 

  10. Cohen I (2004) Endometrial pathologies associated with postmenopausal tamoxifen treatment. Gynecol Oncol 94 (2):256-266.https://doi.org/10.1016/j.ygyno.2004.03.048

    Article  CAS  PubMed  Google Scholar 

  11. Grasel RP, Outwater EK, Siegelman ES, Capuzzi D, Parker L, Hussain SM (2000) Endometrial polyps: MR imaging features and distinction from endometrial carcinoma. Radiology 214 (1):47-52 https://doi.org/10.1148/radiology.214.1.r00ja3647

    Article  CAS  PubMed  Google Scholar 

  12. Sobczuk K, Sobczuk A (2017) New classification system of endometrial hyperplasia WHO 2014 and its clinical implications. Prz Menopauzalny 16 (3):107-111 https://doi.org/10.5114/pm.2017.70589

    Article  PubMed  PubMed Central  Google Scholar 

  13. Malpani A, Singer J, Wolverson MK, Merenda G (1990) Endometrial hyperplasia: value of endometrial thickness in ultrasonographic diagnosis and clinical significance. J Clin Ultrasound 18 (3):173-177. https://doi.org/10.1002/jcu.1870180306

    Article  CAS  PubMed  Google Scholar 

  14. Nalaboff KM, Pellerito JS, Ben-Levi E (2001) Imaging the endometrium: disease and normal variants. Radiographics 21 (6):1409-1424https://doi.org/10.1148/radiographics.21.6.g01nv211409

    Article  CAS  PubMed  Google Scholar 

  15. Takeuchi M, Matsuzaki K, Uehara H, Yoshida S, Nishitani H, Shimazu H (2005) Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol 15 (11):2244-2255. https://doi.org/10.1007/s00330-005-2814-x

    Article  PubMed  Google Scholar 

  16. Nasu K, Sugano T, Miyakawa I (1995) Adenomyomatous polyp of the uterus. Int J Gynaecol Obstet 48 (3):319-321. https://doi.org/10.1016/0020-7292(94)02312-m

    Article  CAS  PubMed  Google Scholar 

  17. Kitajima K, Imanaka K, Kuwata Y, Hashimoto K, Sugimura K (2007) Magnetic resonance imaging of typical polypoid adenomyoma of the uterus in 8 patients: correlation with pathological findings. J Comput Assist Tomogr 31 (3):463-468. https://doi.org/10.1097/01.rct.0000243447.03116.0c

    Article  PubMed  Google Scholar 

  18. Takeuchi M, Matsuzaki K, Harada M (2015) MR manifestations of uterine polypoid adenomyoma. Abdom Imaging 40 (3):480-487. https://doi.org/10.1007/s00261-014-0330-7

    Article  PubMed  Google Scholar 

  19. Parker WH (2007) Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril 87 (4):725-736. https://doi.org/10.1016/j.fertnstert.2007.01.093

    Article  PubMed  Google Scholar 

  20. Ruuskanen AJ, Hippelainen MI, Sipola P, Manninen HI (2012) Association between magnetic resonance imaging findings of uterine leiomyomas and symptoms demanding treatment. Eur J Radiol 81 (8):1957-1964. https://doi.org/10.1016/j.ejrad.2011.04.064

    Article  PubMed  Google Scholar 

  21. Hricak H, Tscholakoff D, Heinrichs L, Fisher MR, Dooms GC, Reinhold C, Jaffe RB (1986) Uterine leiomyomas: correlation of MR, histopathologic findings, and symptoms. Radiology 158 (2):385-391. https://doi.org/10.1148/radiology.158.2.3753623

    Article  CAS  PubMed  Google Scholar 

  22. DeMulder D, Ascher SM (2018) Uterine Leiomyosarcoma: Can MRI Differentiate Leiomyosarcoma From Benign Leiomyoma Before Treatment? AJR Am J Roentgenol 211 (6):1405-1415 https://doi.org/10.2214/ajr.17.19234

    Article  PubMed  Google Scholar 

  23. Kitajima K, Kaji Y, Imanaka K, Sugihara R, Sugimura K (2007) MRI findings of uterine lipoleiomyoma correlated with pathologic findings. AJR Am J Roentgenol 189 (2):W100-104. https://doi.org/10.2214/ajr.07.2230

    Article  PubMed  Google Scholar 

  24. Cramer DW (2012) The epidemiology of endometrial and ovarian cancer. Hematol Oncol Clin North Am 26 (1):1-12. https://doi.org/10.1016/j.hoc.2011.10.009

    Article  PubMed  Google Scholar 

  25. Farrell R, Scurry J, Otton G, Hacker NF (2005) Clinicopathologic review of malignant polyps in stage 1A carcinoma of the endometrium. Gynecol Oncol 98 (2):254-262. https://doi.org/10.1016/j.ygyno.2005.03.044

    Article  CAS  PubMed  Google Scholar 

  26. Akin O, Mironov S, Pandit-Taskar N, Hann LE (2007) Imaging of uterine cancer. Radiol Clin North Am 45 (1):167-182. https://doi.org/10.1016/j.rcl.2006.10.009

    Article  PubMed  Google Scholar 

  27. Sadro CT (2016) Imaging the Endometrium: A Pictorial Essay. Can Assoc Radiol J 67 (3):254-262. https://doi.org/10.1016/j.carj.2015.09.012

    Article  PubMed  Google Scholar 

  28. Wells M, Palacios J, Oliva E, Prat J (2014) Mixed epithelial and mesenchymal tumours. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (eds) WHO Classification of Tumours of Female Reproductive Organs. 4th edn. International Agency for Research on Cancer, Lyon, pp 148-151

    Google Scholar 

  29. Takeuchi M, Matsuzaki K, Harada M (2016) Carcinosarcoma of the uterus: MRI findings including diffusion-weighted imaging and MR spectroscopy. Acta Radiol 57 (10):1277-1284. https://doi.org/10.1177/0284185115626475

    Article  PubMed  Google Scholar 

  30. Tanaka YO, Tsunoda H, Minami R, Yoshikawa H, Minami M (2008) Carcinosarcoma of the uterus: MR findings. J Magn Reson Imaging 28 (2):434-439. https://doi.org/10.1002/jmri.21469

    Article  PubMed  Google Scholar 

  31. Zaloudek C, Norris HJ (1994) Mesenchymal tumors of the uterus. In: Kurman Rs (ed) Blaustein's pathology of the female genital tract. 4th edn. Springer-Verlag, New York, pp 487-528

    Chapter  Google Scholar 

  32. Yoshizako T, Wada A, Kitagaki H, Ishikawa N, Miyazaki K (2011) MR imaging of uterine adenosarcoma: case report and literature review. Magn Reson Med Sci 10 (4):251-254. https://doi.org/10.2463/mrms.10.251

    Article  PubMed  Google Scholar 

  33. Takeuchi M, Matsuzaki K, Yoshida S, Kudo E, Bando Y, Hasebe H, Kamada M, Nishitani H (2009) Adenosarcoma of the uterus: magnetic resonance imaging characteristics. Clin Imaging 33 (3):244-247. https://doi.org/10.1016/j.clinimag.2008.11.003

    Article  PubMed  Google Scholar 

  34. Chen J, Shi J, Gao H, Li J, Li Q, Xie J (2014) Small cell carcinoma of the endometrium: a clinicopathological and immunohistochemical study. Int J Clin Exp Pathol 7 (12):8869-8874

    PubMed  PubMed Central  Google Scholar 

  35. Wan Q, Jiao Q, Li X, Zhou J, Zou Q, Deng Y (2014) Value of (18)F-FDG PET/CT and MRI in diagnosing primary endometrial small cell carcinoma. Chin J Cancer Res 26 (5):627-631. https://doi.org/10.3978/j.issn.1000-9604.2014.10.04

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Silverberg SG, Kurman RJ (1992) Atlas of tumor pathology. Ser. 3. Fasc. 3, Ser. 3. Fasc. 3. In: Rosai J, Aovin L (eds) Atlas of tumor pathology, vol 3. Armed Forces Institute of Pathology, Washington, D.C., pp 91-112

    Google Scholar 

  37. Chen C, Hu YQ, Zhang XM (2017) Magnetic resonance imaging features of endometrial stromal sarcoma: a case description. Quant Imaging Med Surg 7 (1):159-162. https://doi.org/10.21037/qims.2016.11.02

  38. Adiga CP, Gyanchandani M, Goolahally LN, Itagi RM, Kalenahalli KV (2016) Endometrial stromal sarcoma: An aggressive uterine malignancy. J Radiol Case Rep 10 (9):35-43. https://doi.org/10.3941/jrcr.v10i9.2770

    Article  PubMed  PubMed Central  Google Scholar 

  39. Toprak U, Paşaoğlu E, Karademir MA, Gülbay M (2004) Sonographic, CT, and MRI findings of endometrial stromal sarcoma located in the myometrium and associated with peritoneal inclusion cyst. AJR Am J Roentgenol 182 (6):1531-1533. . https://doi.org/10.2214/ajr.182.6.1821531

    Article  PubMed  Google Scholar 

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Lee, Y., Kim, K.A., Song, M.J. et al. Multiparametric magnetic resonance imaging of endometrial polypoid lesions. Abdom Radiol 45, 3869–3881 (2020). https://doi.org/10.1007/s00261-020-02567-7

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