Cervical carcinoma: Comparison of standard and pharmacokinetic MR imaging

被引:59
作者
Hawighorst, H [1 ]
Knapstein, PG [1 ]
Weikel, W [1 ]
Knopp, MV [1 ]
Schaeffer, U [1 ]
Brix, G [1 ]
Essig, M [1 ]
Hoffmann, U [1 ]
Zuna, I [1 ]
Schonberg, S [1 ]
vanKaick, G [1 ]
机构
[1] UNIV MAINZ,DEPT OBSTET & GYNECOL,D-6500 MAINZ,GERMANY
关键词
gadolinium; magnetic resonance (MR); image display; uterine neoplasms; MR; staging;
D O I
10.1148/radiology.201.2.8888254
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To stage advanced cervical carcinoma with conventional or pharmacokinetic magnetic resonance (MR) imaging by correlating imaging findings with whole-mount specimens and histopathologic findings. MATERIALS AND METHODS: Twenty-six adult patients with primary cervical cancer (stages IIB-IVA) underwent T2-weighted turbo spin-echo (SE) MR imaging; gadolinium-enhanced, T1-weighted SE MR imaging; and gadolinium-enhanced, saturation-recovery, turbo fast low-angle shot MR imaging. All imaging findings were correlated with the whole-mount specimens and histopathologic findings. Signal intensity changes versus time were analyzed by using a pharmacokinetic model and parameter values displayed as a color-coded overlay. RESULTS: Histopathologic stages were IIB (n = 9), IIIB (n = 1), and IVA (n = 16). The overall accuracy for tumor staging was 73% for T2-weighted, 81% for T1-weighted, and 92% for pharmacokinetic MR imaging. Pharmacokinetic MR imaging was accurate (90%) in the diagnosis of tumor extension into the bladder and/or rectal wall but inaccurate (69%) in that of parametrial invasion. T2-weighted images were most accurate (86%) in the assessment of parametrial tumor extension but less accurate (69%) in that of bladder or rectal invasion. CONCLUSION: T2-weighted turbo SE images are still superior to contrast medium-enhanced T1-weighted SE or pharmacokinetic MR images in the diagnosis of parametrial infiltration by uterine cervical carcinoma. However, pharmacokinetic MR imaging is a promising method for demonstrating and staging IVA disease.
引用
收藏
页码:531 / 539
页数:9
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