Radiology, Vol 206, 125-129, Copyright © 1998 by Radiological Society of North America

ARTICLES

Parametrial invasion in cervical carcinoma: evaluation of detection at MR imaging with fat suppression

J Scheidler, AF Heuck, M Steinborn, R Kimmig and MF Reiser
Department of Diagnostic Radiology, Klinikum Grosshadern, Ludwig Maximilians University of Munich, Germany.

PURPOSE: To evaluate detection of parametrial invasion at magnetic resonance (MR) imaging with fat suppression. MATERIALS AND METHODS: In 35 patients with cancer of the cervix, MR imaging was performed with the following sequences: T2-weighted turbo spin echo (SE), turbo short inversion time inversion recovery (STIR), and unenhanced or gadolinium- enhanced T1-weighted SE with and without excitation-spoiling fat suppression. Images obtained with each sequence were evaluated for parametrial invasion by two blinded radiologists separately, who scored their level of diagnostic confidence from 0 to 10 (no confidence to high confidence). Then, all images were evaluated together and findings were correlated with histopathologic findings. RESULTS: No statistically significant differences were found between staging with T2-weighted turbo SE, turbo STIR, and T1-weighted fat-suppressed gadolinium-enhanced SE images. Staging with T1-weighted SE, T1-weighted gadolinium-enhanced SE, and T1-weighted fat-suppressed SE images was significantly worse (P < .05). Diagnostic confidence was lower (P < .001) with T1-weighted gadolinium-enhanced SE and T1-weighted fat- suppressed gadolinium-enhanced SE images (5.5 and 6.2 points, respectively) compared to staging with T2-weighted turbo SE and turbo STIR images (8.2 and 7.6 points, respectively). No statistically significant improvement in staging accuracy was found when all images were evaluated together. CONCLUSION: In MR diagnosis of parametrial invasion, the addition of fat-suppressed or gadolinium-enhanced MR images did not improve the accuracy with T2-weighted turbo SE images alone.

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