|ECR 2018 / C-3205|
|Uterine mass in pelvic MRI : the "atypical" myoma puzzle for the radiologist and the gynecologist.|
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.
Thematically related posters
ECR 2018 / C-1838
Multiparametric MRI in prostate cancer: a radiomic study on different diffusion and perfusion models