MR Imaging of Cervical Carcinomas : Comparison between Body Coil, Endorectal Surface Coil and Dynamic Enhanced Images on the Aspect of Parametrial and Vaginal Invasion

To compare fast spin echo(FSE) T2WI of the body coil(BC) with FSE T2WI of the endorectal surface coil(ERC) in the evaluation of parametrial and vaginal invasion and to evaluate tue dynamic enhanced images on the aspect of parametrial invasion.

Twenty consecutive patients of uterine cervical carcinomas confirmed by biopsy were included in this study and staging was determined by the surgery (2 cases) and the radiologic and clinical studies(18 cases). 1.5T Signa(GE,USA) was used and FSE T2-weighted axial and sagittal images were obtained by the body coil and endorectal surface coil respectively. Then dynamic enhanced axial images with FMPSPGR were performed at 2-3 slices of cervical cancer level. Parametrial and vaginal invasion on the body coil images were compared with those on the endorectal coil images retrospectively. Parametrial enhancement was evaluated on the dynamic enhanced images.

The accuracy of parametrial invasion was 100% of BC and 60% of ERC in 5 cases below stage Ib, 64% of BC and 73% of ERG in 11 cases of stage IIb and IIIa, 100% of BC and ERC in 4 cases above stage IVa. Overall accuracy of parametrial invasion was 80% of Bc and 75% of ERC without significant difference between two images. The accuracy of vagianl invasion was 80% of BC and 100% of ERC below stage Ib, 100% of BC and ERC above stage IIb. Overall accuracy of vaginal invasion was 95% of BC and 100% of ERC without difference between two images. On the dynamic enhanced images, parametrial enhancement was seen in all 20 cases and vascular enhancement in the parametrium was noted in 9 pf 20(45%) cases regardless of parametrial invasion.

There was no difference between BC and ERC images to evaluate the accuracy of parametrial and vaginal invasion. Therefore, ERC should be used in the cases which revealed suspicious invasion on BC images. Dynamic-enhanced images were not useful in the evaluation of parametrial invasion.