Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging

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This study evaluated magnetic resonance imaging findings of uterine endometrial cavity pathologies, including benign and malignant neoplasms, pregnancy-related lesions, and fluid collections, to aid in preoperative diagnosis.

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This retrospective study evaluated the magnetic resonance imaging features of various surgically proven pathologies affecting the uterine endometrial cavity, including benign and malignant neoplasms, pregnancy-related lesions, and fluid collections. The authors analyzed diagnostic clues to differentiate these conditions from myometrial lesions that may simulate endometrial abnormalities, such as submucosal leiomyomas and adenomyosis. A key finding was the importance of recognizing specific imaging patterns to avoid diagnostic pitfalls and ensure accurate preoperative assessment of complex uterine diseases. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

The 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.
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Abstract

The 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. Similar content being viewed by others Abbreviations - MRI: - magnetic resonance imaging - T2-WI: - T2-weighted image - T1-WI: - T1-weighted image - SEE: - subendometrial enhancement - LGSS: - low-grade stromal sarcoma - HGSS : - high-grade stromal sarcoma - GTD: - gestational trophoblastic diseases - hCG: - human chorionic gonadotropin

References

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MeSH descriptors

Endometrial Neoplasms Endometrium Magnetic Resonance Imaging Uterine Diseases Adult Endometrial Neoplasms Endometrium Female Humans Middle Aged Retrospective Studies Uterine Diseases

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