{"paper_id":"9d5a5203-f891-40c2-950c-d115fb8223bd","body_text":"Abstract\nThe endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial–myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis.\nSimilar content being viewed by others\nAbbreviations\n- MRI:\n-\nmagnetic resonance imaging\n- T2-WI:\n-\nT2-weighted image\n- T1-WI:\n-\nT1-weighted image\n- SEE:\n-\nsubendometrial enhancement\n- LGSS:\n-\nlow-grade stromal sarcoma\n- HGSS :\n-\nhigh-grade stromal sarcoma\n- GTD:\n-\ngestational trophoblastic diseases\n- hCG:\n-\nhuman chorionic gonadotropin\nReferences\nKurman RJ, Mazur MT (1994) Benign diseases of the endometrium. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 4th edn. Springer, Berlin Heidelberg New York, pp 367–409\nGrasel RP, Outwater EK, Siegelman ES, Capuzzi D, Parker L, Hussain SM (2000) Endometrial polyps: MR imaging features and distinction from endometrial carcinoma. Radiology 214:47–52\nKurman RJ, Norris HJ (1994) Endometrial hyperplasia and related cellular changes. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 4th edn. Springer, Berlin Heidelberg New York, pp 411–437\nAscher SM, Imaoka I, Lage JM (2000) Tamoxifen-induced uterine abnormalities: the role of imaging. Radiology 214:29–38\nSironi S, Colombo E, Villa G, Taccagni G, Belloni C, Garancini P, DelMaschio A (1992) Myometrial invasion by endometrial carcinoma: assessment with plain and gadolinium-enhanced MR imaging. Radiology 185:207–212\nKurman RJ, Zaino RJ, Norris HJ (1994) Endometrial carcinoma. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 4th edn. Springer, Berlin Heidelberg New York, pp 439–486\nLien HH, Blomlie V, Trope C, Kaern J, Abeler VM (1991) Cancer of the endometrium: value of MR imaging in determining depth of invasion into the myometrium. Am J Roentgenol 157:1221–1223\nImaoka I, Sugimura K, Masui T, Takehara Y, Ichijo K, Naito M (1999) Abnormal uterine cavity: differential diagnosis with MR imaging. Magn Reson Imaging 17:1445–1455\nYamashita Y, Harada M, Sawada T, Takahashi M, Miyazaki K, Okamura H (1993) Normal uterus and FIGO stage I endometrial carcinoma: dynamic gadolinium-enhanced MR imaging. Radiology 186:495–501\nJoja I, Asakawa M, Asakawa T, Nakagawa T, Kanazawa S, Kuroda M, Togami I, Hiraki Y, Akamatsu N, Kudo T (1996) Endometrial carcinoma: dynamic MRI with turbo-FLASH technique. J Comput Assist Tomogr 20:878–887\nTanaka YO, Nishida M, Tsunoda H, Ichikawa Y, Saida Y, Itai Y (2003) A thickened or indistinct junctional zone on T2-weighted MR images in patients with endometrial carcinoma: pathologic consideration based on microcirculation. Eur Radiol 13:2038–2045\nZaloudek C, Norris HJ (1994) Mesenchymal tumors of the uterus. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 4th edn. Springer, Berlin Heidelberg New York, pp 487–528\nSahdev A, Sohaib SA, Jacobs I, Shepherd JH, Oram DH, Reznek RH (2001) MR imaging of uterine sarcomas. Am J Roentgenol 177:1307–1311\nShapeero LG, Hricak H (1989) Mixed mullerian sarcoma of the uterus: MR imaging findings. Am J Roentgenol 153:317–319\nGandolfo N, Gandolfo NG, Serafini G, Martinoli C (2000) Endometrial stromal sarcoma of the uterus: MR and US findings. Eur Radiol 10:776–779\nKoyama T, Togashi K, Konishi I, Kobayashi H, Ueda H, Kataoka ML, Kobayashi H, Itoh T, Higuchi T, Fujii S, Konishi J (1999) MR imaging of endometrial stromal sarcoma: correlation with pathologic findings. Am J Roentgenol 173:767–772\nUeda M, Otsuka M, Hatakenaka M, Sakai S, Ono M, Yoshimitsu K, Honda H, Torii Y (2001) MR imaging findings of uterine endometrial stromal sarcoma: differentiation from endometrial carcinoma. Eur Radiol 11:28–33\nBarton JW, McCarthy SM, Kohorn EI, Scoutt LM, Lange RC (1993) Pelvic MR imaging findings in gestational trophoblastic disease, incomplete abortion, and ectopic pregnancy: are they specific? Radiology 186:163–168\nPreidler KW, Luschin G, Tamussino K, Szolar DM, Stiskal M, Ebner F (1996) Magnetic resonance imaging in patients with gestational trophoblastic disease. Invest Radiol 31:492–496\nGreen CL, Angtuaco TL, Shah HR, Parmley TH (1996) Gestational trophoblastic disease: a spectrum of radiologic diagnosis. Radiographics 16:1371–1384\nWagner BJ, Woodward PJ, Dickey GE (1996) From the archives of the AFIP. Gestational trophoblastic disease: radiologic-pathologic correlation. Radiographics 16:131–148\nMazur MT, Kurman RJ (1994) Gestational trophoblastic disease and related lesions In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 4th edn. Springer, Berlin Heidelberg New York, pp 1049–1093\nKurachi H, Maeda T, Murakami T, Tsuda K, Sakata M, Nakamura H, Miyake A (1995) MRI of placental polyps. J Comput Assist Tomogr 19:444–448\nTanaka YO, Shigemitsu S, Ichikawa Y, Sohda S, Yoshikawa H, Itai Y (2004) Postpartum MR diagnosis of retained placenta accreta. Eur Radiol 14:945–952\nUeda H, Togashi K, Konishi I, Kataoka ML, Koyama T, Fujiwara T, Kobayashi H, Fujii S, Konishi J (1999) Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. Radiographics 19(Spec No):S131–S145\nReinhold C, Tafazoli F, Mehio A, Wang L, Atri M, Siegelman ES, Rohoman L (1999) Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. Radiographics 19 (Spec No):S147–160\nYamashita Y, Torashima M, Hatanaka Y, Takahashi M, Fukumatsu K, Tanaka N, Miyazaki K, Okamura H (1995) MR imaging of atypical polypoid adenomyoma. Comput Med Imaging Graph 19:351–355\nAuthor information\nAuthors and Affiliations\nCorresponding author\nAdditional information\nThis paper was presented at ECR 2004 (C-407) and awarded Magna Cum Laude\nRights and permissions\nAbout this article\nCite this article\nTakeuchi, M., Matsuzaki, K., Uehara, H. et al. Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol 15, 2244–2255 (2005). https://doi.org/10.1007/s00330-005-2814-x\nReceived:\nRevised:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00330-005-2814-x","source_license":"CC0","license_restricted":false}