Distinguishing uterine malignant mixed mullerian tumors (MMMTs) from endometrial carcinomas preoperatively by pelvic MRI may help with surgical and treatment planning of this highly aggressive tumor. Our study found that prolapse of tumor through the external cervical os, delayed iso- or hyper-enhancement, high mean tumor: myometrium positive enhancement integral (PEI) ratio and low tumor signal enhancement ratio (SER) are more commonly seen in patients with MMMT and may alert the radiologist to the possibility of this diagnosis.
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