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Master Thesis

Diagnostic préopératoire des carcinosarcomes de l’endomètre grâce à l’IRM

Abstract : Objective: to describe MRI characteristics of endometrial carcinosarcoma (CS) including enhanced and diffusion sequences in comparison with endometrioid carcinoma (EC). Materials & methods: retrospective study from Curie Institute histopathologic database. From 2003 to 2018, patients with CS or EC who had preoperative MRI were included. Morphological, perfusion (maximum relative enhancement (SIRel) and wash-in rate (WIR)) and diffusion weighted data were analyzed. T2 signal heterogeneity, necrosis, hemorrhage, intensity and heterogeneity of enhancement were recorded by two radiologists. Inter-reader agreement was calculated using Cohen k statistics. Results: 91 patients (36 CS and 55 EC) were included. CS size was greater than EC (82mm vs 38mm; p<0,001) as for cavity dilatation (43mm vs 19mm ; p<0,001). In comparison with EC, CS were more often heterogenous in T2 weighted (97% vs 38%; p<0,001 ; k=0,88), necrotic (70% vs 13% ; p<0,001 ; k=1) hemorrhagic (83% vs 25% ; p<0,001 ; k=0,95). CS enhanced more often greater or equally to myometrium (94% vs 44%; p<0,001 ; k=0,85) and heterogeneously (97% vs 55% ; p<0,001 ; k=0,94) in comparison with EC. SIRel and WIR were greater in CS than in EC (92% vs 63% et 46% vs 36% ; p=0,01). CS were more often in hypersignal diffusion in comparison with EC (100% vs 65%; p=0,02) but no statistical difference was found about ADC values. Conclusion: a bulky endometrial mass, necrotic and hemorrhagic, enhancing greater or equally to myometrium suggest the diagnosis of CS.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02299140
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Lucas Rivière. Diagnostic préopératoire des carcinosarcomes de l’endomètre grâce à l’IRM. Médecine humaine et pathologie. 2018. ⟨dumas-02299140⟩

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