Advisor(s)
Abstract(s)
O carcinoma do endométrio apresenta uma
taxa de incidência em Portugal de cerca de
7.2%, sendo a 5ª neoplasia mais comum na
mulher. Apesar de apresentar uma prevalência
relativamente elevada, o seu prognóstico global
é favorável, uma vez que 75% dos casos são
diagnosticados em estádio precoce.
O estudo por ressonância magnética é geralmente
efectuado após a realização de uma ecografia para
avaliação de uma hemorragia uterina anormal e
após o diagnóstico histológico por histeroscopia
ou ressecção. Contudo, a ressonância magnética
pode apresentar um papel determinante no
diagnóstico em casos de impossibilidade de
biópsia e nos quais a biópsia é inconclusiva.
Além do mais, apesar de esta técnica não ser
contemplada na classificação para o estadiamento
do carcinoma do endométrio da International
Federation of Gynecology and Obstetrics de
2009, apresenta uma função fundamental no
estadiamento pré-operatório destas doentes,
sendo crucial para definir a abordagem cirúrgica
e terapêutica.
No presente artigo, as autoras descrevem o estado
da arte da ressonância magnética funcional no
diagnóstico e no estadiamento do carcinoma do
endométrio, chamando a atenção para o papel do
estudo dinâmico após administração de contraste
endovenoso e do estudo ponderado em difusão
nestes cenários através da revisão da literatura
mais recente sobre este tópico.
Endometrial cancer incidence rate in Portugal is approximately of 7.2%, being the 5th most common malignancy in females worldwide. Despite its relatively high prevalence, the overall prognosis is generally good since 75% of endometrial cancer is diagnosed at an early stage. Magnetic resonance imaging is usually performed after an ultrasound study for the workup of an abnormal uterine bleeding and after the histologic diagnose of endometrial cancer by hysteroscopy or resection. However, it may play a role in the diagnosis of endometrial carcinoma when histology is inconclusive or when biopsy cannot be performed. Moreover, although it is not considered in the International Federation of Gynaecology and Obstetrics 2009 staging classification, it has a crucial role in pre-operative staging, being an essential tool for tailoring the surgical and therapeutic approach. The authors describe the state-of-the-art of functional magnetic resonance imaging in the diagnosis and staging of endometrial carcinoma, drawing attention to the role of dynamic contrast-enhanced and diffusion-weighted imaging in these settings and revising the current literature on this topic.
Endometrial cancer incidence rate in Portugal is approximately of 7.2%, being the 5th most common malignancy in females worldwide. Despite its relatively high prevalence, the overall prognosis is generally good since 75% of endometrial cancer is diagnosed at an early stage. Magnetic resonance imaging is usually performed after an ultrasound study for the workup of an abnormal uterine bleeding and after the histologic diagnose of endometrial cancer by hysteroscopy or resection. However, it may play a role in the diagnosis of endometrial carcinoma when histology is inconclusive or when biopsy cannot be performed. Moreover, although it is not considered in the International Federation of Gynaecology and Obstetrics 2009 staging classification, it has a crucial role in pre-operative staging, being an essential tool for tailoring the surgical and therapeutic approach. The authors describe the state-of-the-art of functional magnetic resonance imaging in the diagnosis and staging of endometrial carcinoma, drawing attention to the role of dynamic contrast-enhanced and diffusion-weighted imaging in these settings and revising the current literature on this topic.
Description
Keywords
Cancro do endométrio Imagem por ressonância magnética Ginecologia Radiologia Imagem de ressonância magnética ponderada em difusão Endometrial cancer Magnetic resonance imaging Gynaecology Radiology Diffusion magnetic resonance Imaging
Citation
Mariana Horta; Teresa Margarida Cunha. Pre-Treatment Magnetic Resonance Stratification of Endometrial Carcinoma – The Role of Dynamic Contrast-enhanced and Diffusion-Weighted Imaging, Acta Radiológica Portuguesa, 27, 106, 31-39, 2015.