Endometrial polyp with pedicle artery sign (MRI)

Case contributed by Luu Hanh
Diagnosis certain

Presentation

Postmenopausal bleeding

Patient Data

Age: 70 years
Gender: Female
This study is a stack
Axial T1
fat sat
This study is a stack
Axial
T2
This study is a stack
Axial T1
in-phase
This study is a stack
Axial T1
out-of-phase
This study is a stack
Axial
DWI
This study is a stack
Coronal
T2
This study is a stack
Sagittal
T2
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
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Info

There is a mass in the endometrial cavity. It shows heterogeneous high signal on T2, heterogeneous low signal on T1 compared with myometrium, enhances less than myometrium on T1C+; a single feeding vessel extends to the mass consistent with pedicle artery sign.
The lesion appears to invade the anterior myometrial wall.
The uterus presents atrophy change.
The anterior abdominal wall hernia is seen.

T2
T1C+
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Info

The mass measuring 10x26 mm
Yellow arrow: pedicle artery

The hysterectomy was performed, histopathology confirms the benign polyp of the endometrium.  

Case Discussion

This case demonstrates the imaging features of endometrial polyps with pedicle artery sign on MRI.

The differential diagnosis includes endometrial hyperplasiaendometrial carcinoma.

The pedicle artery sign on transvaginal color Doppler sonography has a sensitivity of 86.67%, an accuracy of 86.67%, a positive predictive value of 100%, and no false positive. It improves the specificity for the diagnosis of endometrial polyps 1.

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