Magnetic Resonance Imaging (MRI) Assess Staging Of Cervical Carcinoma In Clinical Study

Department of Gynecology and Obstetrics, Jincheng Mine Group Co.Ltd General Hospital, Shanxi Provice Advisor: Li Li, Hao Qiu-fangDepartment of Gynecology and Obstetrics,the First Clinical Institute, Shanxi Medical UnivercityObjective: Cervical cancer is one of the most common gynecologic malignancies. The extent of the disease defined by clinical staging is generally the main determinant guiding the therapy choices and affecting the prognosis of patients. Clinical staging based on findings from physical examination, lesion biopsy, endoscopic evaluation of the urinary bladder and rectosigmoid colon, and radiologic examination including intravenous urography and barium enema has limitations. When compared with surgical staging, clinical staging is subject to reported errors of 35% to 39%. Magnetic resonance imaging (MRI), with multiplanar capabilities and superb soft tissue resolution, is a reliable staging modality in the evaluation of cervical cancer. The purpose of this study was to investigate the role of MRI in the preoperative assessment of cervical cancer .Methods: The prospective study was conducted between June 2001 and March 2003 in Jincheng Mine Group Co.Ltd General Hospital, Shanxi Province. Thirty-three patients, aged 30 to 76 years (mean, 50.4year), who underwent operation for cervical carcinoma were enrolled. MRI was performed in women with tissue-proven cervical carcinoma 3-7 days prior to surgery. Images were analyzed and recordered for parametrial invasion ,pelvic lymph node metastasis and tumor stage. The results were compared with the histopathologic findings after surgery in all patients.Results: MRI findings of cervical cacinoma were very characteristic and had super soft tissue resolution. The accuracy of MR imaging in determination of tumor location was 88.9%. The accuracy, specificity, and sensitivity for parametrial extension were 94%, 96%, and 90%, respectively. In determining stage of disease, MRI had an accuracy of 75.7%. The accuracy of MRI in differentiating localized ( stage IIA) from advanced disease (stage IIB) was 94%.Conclution: MRI imaging can show the local tumor 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. MRI is accurate in the evaluation of parametrial invasion and lymph node metastases and in the differentiation of localized and advanced disease. MRI is beneficial in planning treatment for patients with cervical cancer and should be regarded as a routine preoperative imaging study for cervical carcinoma.