MRI diagnosis and staging of cervical carcinoma

Objective To study the MRI features of uterine cervical carcinoma and to evaluate the value of MR imaging in preoperative staging of uterine cervical carcinoma. Methods Pelvic MR imaging was performed in 98 patients with cervical carcinoma proved by pathology including 45 patients with operation. MRI was performed within 3 days～15 days (average 7.5 days) before operation. The MRI scanning included axial SE T 1WI, axial and sagittal TSE T 2WI, coronal SPIR TSE T 2WI, and axial, sagittal, and coronal Gd DTPA enhanced SE T 1WI. MR images were analyzed for location, signal characteristics, and extension of the primary tumor. MR findings were compared with surgical pathologic findings. Results MRI findings of cervical carcinoma were very characteristic, which appeared as moderate hyperintensity on T 2WI, and there was a significant contrast noise ratios among the cervical carcinoma, normal cervix, and the parametrial tissue. The tumor showed hypointense on T 1WI, and mild enhancement after bolus intravenous Gd DTPA. In 33 patients, the signal of the tumor was heterogeneous, which was caused by pseudoglandular lumen, necrosis, and keratin pearl. The accuracy of MR imaging in determination of tumor location was 100%. The accuracy, specificity, and sensitivity for parametrial extension were 88.9%, 90.6%, and 84.6%, respectively. Overall, the accuracy of MR imaging in staging was 88.9%. Conclusion MRI imaging can show the local tumors and extension of the cervical carcinoma clearly on multi planes and angles. MR imaging is superior to clinical evaluation in the staging of uterine cervical carcinoma, and should be regarded as a routine preoperative imaging study for cervical carcinoma.