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Clinical utility of susceptibility-weighted MR sequence for the evaluation of uterine sarcomas

      Highlights

      • Intra-tumoral hemorrhagic necrosis is suggestive for uterine sarcoma.
      • High intensity on T1WI is characteristic but the prevalence varies.
      • Susceptibility-weighted MR sequences such as SWAN are sensitive for the blood products.
      • MRI of 10 uterine sarcomas and 24 leiomyomas were evaluated.
      • The accuracy, sensitivity, and specificity for SWAN were 97%, 100%, and 96%, respectively.

      Abstract

      Purpose

      High intensity intra-tumoral hemorrhagic necrosis on T1-weighted images is a suggestive finding for uterine sarcomas, however, the reported prevalence varies. The purpose of this study is to evaluate the capability of susceptibility-weighted MR sequences (SWS) for the diagnosis of uterine sarcomas.

      Materials and methods

      MR imaging of surgically proven 10 uterine sarcomas and 24 benign leiomyomas were retrospectively evaluated for the presence of high intensity areas on T1-weighted images and signal voids on SWS (T2 star-weighted angiography: SWAN).

      Results

      High intensity areas on T1-weighted images and signal voids on SWS were observed in 40% and 100% of sarcomas, whereas 0% and 4% of leiomyomas, respectively. The accuracy, sensitivity, and specificity for T1-weighted images were 82%, 40%, and 100%, and for SWS were 97%, 100%, and 96%, respectively.

      Conclusion

      The demonstration of intra-tumoral hemorrhage in patients suspected with uterine sarcomas by SWS may provide valuable diagnostic findings.

      Keywords

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