MRI Diagnosis In The Pelvic Malignant Tumors Of Gynecology

Objective:1. To discuss the veracity of MRI in the orientation and the qualitative analysis for gynecology malignant tumors; to describe the characteristic MRI representation of malignant tumors in different FIGO stage; to provide some imaging evidence for the choice of clinical treatment project.2. To discuss the MRI scanning sequences of female pelvis and their best optimizing combination.Material and methods:51 patients who were suspected to be ill with malignant tumors of female pelvic in the clinical diagnosis and suggested to have a MRI examination. After the operation or pathological confirmation, 42 of them were proved to be ill with malignant tumors of female pelvic. All cases had the MRI examination. All cases were examined with 1.5 T magnetic resonance machine. Three-planar( axial, sagittal, coronal ) scans were performed. Part of these cases were went three-planar enhanced scan. Examination sequences include SE sequence, FSE sequence, SPGR sequence. Seven cases had the CT examination simultaneously.Results:In 42 patients of malignant tumors, 7 cases were endometrial cancer (6 cases were adenocarcinoma, 1 case was transparent cell carcinoma ); 18 cases were cervical cancer (15 cases were squamous cell carcinoma, 3 cases were adenocarcinoma); 11 cases were ovarian malignant tumors (5 cases were adenocarcinoma, 2 cases were immature teratoma, 1 case was Krukenbergs' tumor, 3 cases were recrudescent tumor); 3 cases were metastasis (all of them were adenocarcinoma); 1 case was primary squamous cell carcinoma of fallopian tube ; 1 case was primary vaginal squamous cell carcinoma ; 1 case was choriocarcinoma. The primary tumors appear a solid soft tissue mass which was iso-intensity on T1-weighted and was also iso-intensity on T2-weighted, but it appears high signal intensity on fatty saturation of T2-weightedsequence. So we call it "relative high signal intensity". According to the contrast between MRI stages and histological findings(tumor invasion depth and lymph-node involvement etal), the veracity of MRI is 88.89%. the NPV is 77.78%.Conclusion:1. MRI can make an all-round evaluation for the malignant tumors of female pelvis . Therefore, MRI should be the regular examination method of female pelvic tumors before clinical treatment.2. The primal malignant tumors of uterus and cervix have characteristic signal appearance on MRI films.3. MRI is better than CT at the follicular structure, encroaching of Fallopian tube, peritoneal metastasis and so on.4. Imaging needs to be closely related to the clinical examination of gynecology and the pathological classification, which could supply a more complete and veracious prediction and evaluation for tumors.5. The plain scan of MRI is a good choice for female pelvic tumors stages. And enhancement scan is an effective complement of it.