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Multicystic mucinous adenocarcinoma of the uterine cervix compared with benign multicystic lesions: Multiparametric MR features
Author(s) -
Song Jiacheng,
Hu Qiming,
Huang Junwen,
Ma Zhanlong,
Chen Ting
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26038
Subject(s) - medicine , effective diffusion coefficient , diffusion mri , adenocarcinoma , receiver operating characteristic , radiology , nuclear medicine , magnetic resonance imaging , pathology , cancer
Background Multicystic mucinous adenocarcinoma is rarely recognized and has a high misdiagnosis rate. Purpose To distinguish malignant multicystic mucinous adenocarcinomas from benign multicystic lesions in the uterine cervix using multiparametric MR. Study Type Retrospective. Population Forty patients with seven cystic mucinous adenocarcinomas and 33 benign multicystic lesions. Field Strength/Sequence 3.0T. Diffusion‐weighted images (DWI) and dynamic contrast‐enhanced (DCE) images. Assessment Lesion size, intracystic hemorrhage, solid component, and heterogeneous enhancement were subjectively assessed, and apparent diffusion coefficient (ADC) values, K trans , K ep , and V e parameters were compared. Statistical Analysis Student's t ‐test was used to compare age, tumor size, ADC values, and DCE parameters. Pearson's chi‐square test was used to compare intracystic hemorrhage, solid component, and heterogeneous enhancement. Receiver‐operating‐characteristic (ROC) analysis of ADC values, tumor size, and K trans were performed. Results The size of mucinous adenocarcinomas was larger than benign multicystic lesions (4.09 ± 2.09 vs. 2.23 ± 0.58 cm, P < 0.001); the area under the curve (AUC) for tumor size was 0.859 with a sensitivity of 71.4% and specificity of 90.9%. Stromal ADC value was lower for mucinous adenocarcinomas (1.19 ± 0.22 vs. 1.68 ± 0.22 × 10 −3 mm 2 /s, P < 0.001); AUC for stromal ADC value was 0.970, with a sensitivity of 86.4% and specificity of 100.0%. Among quantitative DCE parameters, only k trans offered a discriminative value (1.72 ± 1.42 vs. 0.69 ± 0.30 min −1 , P = 0.031); the AUC for k trans was 0.831 with a sensitivity of 71.4% and specificity of 97.0%. Intracystic hemorrhage (3/7), solid component (5/7), and heterogeneous enhancement (4/7) were only found in mucinous adenocarcinomas. Five patients (71.4%) had lymphovascular space invasion and three (42.9%) had lymph node metastasis. The 1‐year tumor recurrence or metastasis rate was 28.5% (2/7). Data Conclusion Awareness of multiparametric MR features can assist in the differentiation of mucinous adenocarcinomas from benign multicystic lesions. Level of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1336–1343.