Abstract
Endometrial carcinomas (ECs) exhibit well-recognized characteristics on MRI sequences. In T2-weighted imaging (T2WI), the tumor presents as a diffuse or well-delineated soft tissue mass with an epicenter in the endometrial cavity and a heterogeneous intermediate signal relative to the hyperintense normal endometrium and hypointense myometrium. In diffusion-weighted imaging (DWI), tumors are hyperintense at a high b value in correspondence with the hypointense signal in the apparent diffusion coefficient (ADC) map. In dynamic contrast-enhanced MRI (DCE-MRI), endometrial tumors can show slower enhancement than the myometrium in the early phases and a hypointense signal in the later phases. In summary, dynamic sequences assist in the evaluation of continuous enhancement of the subendometrial zone (best evaluated approximately 35–40 seconds after the injection of gadolinium) and the estimated degree of myometrial invasion (best evaluated during the equilibrium phase—2.5 minutes after the injection of the contrast) and permit an adequate evaluation of the presence of infiltration of the cervical stroma (CSI), ideally evaluated 4 to 5 minutes after the injection of the contrast.1
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