Seki H, Azumi R, Kimura M, Sakai K
Department of Radiology, Niigata University School of Medicine, Japan.
AJR Am J Roentgenol. 1997 Jun;168(6):1579-85. doi: 10.2214/ajr.168.6.9168730.
The purpose of this study was to evaluate dynamic MR imaging in assessing the depth of stromal invasion by carcinoma of the cervix and to compare dynamic MR imaging with T2-weighted and contrast-enhanced T1-weighted MR imaging.
Forty-one patients with carcinoma that was clinically considered to be confined to the cervix were examined with T2-weighted, dynamic, and contrast-enhanced T1-weighted MR imaging before surgery. We evaluated enhancement patterns of the cervix and tumor and assessed the degree of stromal invasion with MR imaging. The degree of stromal invasion was divided into two groups: superficial disease (no stromal invasion or invasion of < or = 3 mm) and deep invasion (> 3 mm of stromal invasion). Then we compared these MR findings with histologic results for the depth of stromal invasion.
With dynamic MR imaging, cervical carcinoma with deep invasion was seen as a focal enhanced area in the early dynamic phase. The cervical epithelium and stroma enhanced less vividly. In distinguishing deep invasion from superficial disease, we found the accuracy of T2-weighted MR images, dynamic MR images, and contrast-enhanced T1-weighted MR images to be 76%, 98%, and 63%, respectively. In particular, the detectability of 3.1-5.0 mm of stromal invasion with dynamic MR images was significantly higher than that with the other techniques: with T2-weighted MR images, we saw 3.1-5.0 mm of stromal invasion in 23% of patients; with dynamic MR images, in 92%; and with contrast-enhanced T1-weighted MR images, in none. Superficial disease was not revealed with any of the three MR techniques.
We believe that dynamic MR imaging is superior to T2-weighted MR imaging and contrast-enhanced T1-weighted MR imaging when assessing the depth of invasion of cervical carcinoma.
本研究旨在评估动态磁共振成像在评估宫颈癌基质浸润深度方面的作用，并将动态磁共振成像与T2加权和对比增强T1加权磁共振成像进行比较。
41例临床诊断为局限于宫颈的癌患者在手术前行T2加权、动态及对比增强T1加权磁共振成像检查。我们评估了宫颈和肿瘤的强化模式，并通过磁共振成像评估基质浸润程度。基质浸润程度分为两组：浅表病变（无基质浸润或浸润深度≤3mm）和深部浸润（基质浸润深度>3mm）。然后我们将这些磁共振成像结果与基质浸润深度的组织学结果进行比较。
通过动态磁共振成像，深部浸润的宫颈癌在动态早期表现为局灶性强化区。宫颈上皮和基质强化不明显。在区分深部浸润和浅表病变时，我们发现T2加权磁共振图像、动态磁共振图像和对比增强T1加权磁共振图像的准确率分别为76%、98%和63%。特别是，动态磁共振图像对3.1 - 5.0mm基质浸润的检测能力显著高于其他技术：T2加权磁共振图像显示23%的患者有3.1 - 5.0mm的基质浸润；动态磁共振图像显示92%的患者有；对比增强T1加权磁共振图像未显示。三种磁共振技术均未发现浅表病变。
我们认为，在评估宫颈癌浸润深度时，动态磁共振成像优于T2加权磁共振成像和对比增强T1加权磁共振成像。
