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. 2020 May 4;10:7404. doi: 10.1038/s41598-020-64285-w

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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A 32-year-old nulliparous patient with 6 months of abnormal uterine bleeding and a heterogeneous myometrial mass on her ultrasound. (a) Sagital T2 MR-image detected a large predominantly hyper-signal lesion in posterofundal myometrium with anterior endometrial displacement; Tumor-Myometrial Contrast (TM) Ratio = 0.83; T2-scaled Ratio = 0.2 and T2 map = 42. (b) Axial DW image and (c) ADC revealed no evidence of restriction with mean ADC of 1.3 mm/s². (d) Axial post-contrast T1 image in equilibrium phase showed the mass with mild enhancement significantly less than myometrium and without any central necrosis. Tumor-Myometrium Contrast Enhanced (TMCE) Ratio = −0.64. If we put this sample data in either of simple or complex decision-tree, the pathology could be predicted as “benign”. Eventually, the histo-pathological exam confirmed a benign tumor, degenerated leiomyoma.