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753

Carcinoma

of the Cervix:

MR Imaging Involvement

in Detecting

Value of

Parametrial

F Sandro Carlo

Sironi1 Belloni2

In patients

affects

Gian Luca Taccagni3 Alessandro DelMaschio1

with cervical

the therapeutic

this prospective

presence

carcinoma,

decision

study

was

precise

knowledge

surgery

between

to determine

of parametnal

and radiation

the efficacy

tumor

therapy.

of MR imaging

extension

The purpose in detecting

of the

or absence

of parametnal invasion in patients with cervical cancer thought to the cervix. Twenty-five consecutive patients were included underwent radical hysterectomy or total abdominal hysterechistologic evaluation of the parametrium. Ten had pathologic evidence of parametrial invasion; in the remaining 15, no parametrial invasion was identified pathologically. MR findings were compared with pathologic findings in all cases. For determining parametrial involvement, MR imaging had an accuracy of 88%, a sensitivity of 100%, and a specificity of 80%. Our results suggest that MR imaging is a reliable means of assessing parametnal invasion by cervical cancer. clinically to be confined in the study. All patients tomy and had detailed

156:753-756,

AJR

April

1991

Uterine cervical carcinoma is one of the most common gynecologic malignant neoplasms. Surgery is usually reserved for patients with tumor confined to the cervix, whereas patients with parametrial involvement or more advanced disease are referred for radiation therapy [1 ]. Thus, an important question in staging carcinoma

degree

of the cervix

is whether

of parametrial

examination. Clinical Previous studies accurate assessment

tumor

the tumor

extension

detecting examination Subjects

.

to the cervix. were

Raffaele,

University

Hospital,

20132 Milan, Italy. 3

Department

Raffaele, University Hospital, Roentgen

Institute

20132 Milan, Italy.

0361-803X/91/1564-0753 0 American

histologic in the

Ray Society

S.

and

diagnosis

study

were

study

of regional

was to determine

.

.

they

not

with

because

undergo

extension

the efficacy

of the

of MR imaging

of clinical

.

was based Obstetrics.

of colposcopic

to have

advanced

radiation

surgery.

ness of the MR examination Clinical staging Gynecology and

by means

considered

with preinvasive

Patients

excluded do

of the disease clinically

Patients

excluded.

also were

of Pathology, Scientific

of the present

in the evaluation

Twenty-five consecutIve patients 33-69 years old with pnmary untreated carcinoma of the cervix were included in a ProsPective study. All patients were referred for MR imaging after

entific

S.

The

by clinical

and Methods

Raffaele, University Hospital, Olgettina 60, 20132 Milan, Italy. Address reprint requests to S. Sironi. 2 Department of Gynecology and Obstetrics, SdInstitute

mainly

parametrial invasion in patients considered on the basis to have cervical carcinoma confined to the cervix.

in

Received August 7, 1990; accepted after revision October 1 8, 1 990. 1 Department of Radiology, Scientific Institute S.

into the parametrium.

assessed

staging, however, is often inaccurate [2]. suggest that sonography and CT are limited in providing of tumor extent [3-6]. Recently, several studies have em-

phasized the value of MR imaging disease [7-13]. The purpose

extends

has been

No

or refusal

invasive

tumor

(in situ) cervical tumor stages

of disease

therapy patients

biopsy. All 25 patients included (