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Thus, accurate diagnosis is essential, and following initial clinical and sonographic assessments, MRI serves as the cornerstone imaging technique for further characterization and differential diagnosis. Radiologists must be familiar with and adept at interpreting these images to narrow the differential diagnosis and at least suggest the possibility of EST. This article describes the imaging manifestations of various ESTs and highlights characteristic radiological features that enable radiologists to refine the differential diagnosis, thereby assisting clinicians in determining appropriate treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:bold>Question<\/jats:bold>\n                            Preoperative differentiation of ESTs from benign uterine lesions remains challenging and may result in the adoption of the incorrect surgical approach.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:bold>Findings<\/jats:bold>\n                            Key MRI features include homogeneous T2WI hyperintensity without speckles, T2WI hypointense bands, a worm\u2011like appearance, multilocular cystic changes, and feather\u2011like enhancement.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:bold>Critical Relevance Statement<\/jats:bold>\n                            This review comprehensively describes the MRI findings of ESTs and provides an educational summary based on tumor location, morphology, and key features to substantially improve diagnostic confidence.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13244-026-02400-7","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:42:53Z","timestamp":1790001773000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MRI insights into endometrial stromal tumors"],"prefix":"10.1186","volume":"17","author":[{"given":"Le","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-Wen","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2922-3334","authenticated-orcid":false,"given":"Yu","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"2400_CR1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.maturitas.2012.01.021","volume":"72","author":"R Koivisto-Korander","year":"2012","unstructured":"Koivisto-Korander R, Martinsen JI, Weiderpass E, Leminen A, Pukkala E (2012) Incidence of uterine leiomyosarcoma and endometrial stromal sarcoma in Nordic countries: results from NORDCAN and NOCCA databases. 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