Using Multiparametric MRI To Differentiate Uterine Sarcoma From Uterine Cellular Leiomyoma

ObjectiveTo explore the value of clinical parameters and qualitative and quantitative magnetic resonance imaging（MRI）features in the differentiation between uterine sarcoma（US）and cellular leiomyoma（CL）.MethodsRetrospective analysis of clinical data of 56 US and 44 CL patients confirmed by pathology from January 2011 to December 2019 in our hospital,clinical data include patient age,BMI,reproductive history,menopause,clinical symptoms,Laboratory examination and MRI data include tumor location,maximum diameter,T1WI,T2WI,DWI signal intensity,and margin on T2WI,DWI and DCE dynamic enhancement sequence quantitative parameters.The receiver operating characteristic（ROC）curve is used to evaluate the level of diagnostic efficiency.ResultsThere were significant differences between US and CL in the following qualitative MRI parameters:LMS was mainly located in the uterine cavity or submucosal with an ill-defined margin on T2WI and showed heterogeneous signal on T2WI（P<0.05）.For quantitative MRI parameters,mean apparent diffusion coefficient（Mean ADC）values,min apparent diffusion coefficient（Min ADC）values,early enhancement ratio（EER）,maximum contrast enhancement ratio（MCER）of the solid component of US could help to distinguish from CL（P<0.05）.According to receiver operating characteristic（ROC）curves,when the cut-off values of Mean ADC was 1.115×10^-3mm²/s and Min ADC was 0.882×10^-3mm²/s,the sensitivity and specificity were 88.6%、64.3%and 90.9%、57.1%,respectively.ConclusionIt was valuable to use multiparametric MRI to differentiate US from CL.