Endometrial cancer is isointense relative to hypointense normal endometrium on unenhanced T1-weighted images and most commonly shows heterogeneous intermediate signal intensity relative to hyperintense normal endometrium on T2- weighted images (Figs 1–3)
Relative to normal myometrium, the tumor is mildly hyper- intense on T2-weighted images.
Endometrial tumors enhance earlier than does normal endometrium after the administration of intravenous contrast medium, which aids in the detection of small tumors confined to the endo- metrial complex. Normal myometrium enhances intensely compared with hypointense endometrial tumor. Maximum contrast between hy- perintense myometrium and hypointense endome- trial tumor occurs 50–120 seconds after contrast medium administration, and this is the most important phase for accurate assessment of the depth of myometrial invasion. Delayed- phase images obtained 3–4 minutes after contrast medium administration are useful in evaluating for cervical stromal invasion (FIGO stage II).
Endometrial cancer exhibits impeded diffusion compared with surrounding tissue, manifesting with high signal intensity on diffusion-weighted MR images and low signal intensity on ADC maps, which provide a quantitative measure of water diffusion
Consideraciones:
Tumors with endocervical glandular invasion are now considered stage I tumors, and tumors with cervical stromal invasion are defined as stage II tumors
The presence of an intact enhancing cervical mucosa excludes stromal invasion.
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