Bi Q, Xiao Z, Lv F, Liu Y, Zou C, Shen Y. Utility of Clinical Parameters and Multiparametric MRI as Predictive Factors for Differentiating Uterine Sarcoma From Atypical Leiomyoma.
Acad Radiol 2018;
25:993-1002. [PMID:
29422425 DOI:
10.1016/j.acra.2018.01.002]
[Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES
The objective of this study was to find clinical parameters and qualitative and quantitative magnetic resonance imaging (MRI) features for differentiating uterine sarcoma from atypical leiomyoma (ALM) preoperatively and to calculate predictive values for uterine sarcoma.
MATERIALS AND METHODS
Data from 60 patients with uterine sarcoma and 88 patients with ALM confirmed by surgery and pathology were collected. Clinical parameters, qualitative MRI features, diffusion-weighted imaging with apparent diffusion coefficient values, and quantitative parameters of dynamic contrast-enhanced MRI of these two tumor types were compared. Predictive values for uterine sarcoma were calculated using multivariable logistic regression.
RESULTS
Patient clinical manifestations, tumor locations, margins, T2-weighted imaging signals, mean apparent diffusion coefficient values, minimum apparent diffusion coefficient values, and time-signal intensity curves of solid tumor components were obvious significant parameters for distinguishing between uterine sarcoma and ALM (all P <.001). Abnormal vaginal bleeding, tumors located mainly in the uterine cavity, ill-defined tumor margins, and mean apparent diffusion coefficient values of <1.272 × 10-3 mm2/s were significant preoperative predictors of uterine sarcoma. When the overall scores of these four predictors were greater than or equal to 7 points, the sensitivity, the specificity, the accuracy, and the positive and negative predictive values were 88.9%, 99.9%, 95.7%, 97.0%, and 95.1%, respectively.
CONCLUSIONS
The use of clinical parameters and multiparametric MRI as predictive factors was beneficial for diagnosing uterine sarcoma preoperatively. These findings could be helpful for guiding treatment decisions.
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