Carcinoma of the cervix: value of plain and gadolinium-enhanced MR imaging in assessing degree of invasiveness

The accuracy of nonenhanced spin-echo (SE) T2-weighted and contrast material-enhanced SE T1-weighted magnetic resonance (MR) imaging in assessing the degree of local tumor invasion was determined prospectively in 53 consecutive patients with clinically established early-stage carcinoma of the cervix. With a 0.5-T superconducting unit, pulse sequences of 2,000/90 (repetition time msec/echo time msec) for T2-weighted images and 500/20 for T1-weighted images were used. In all cases, findings of the two MR imaging techniques were compared with results of histologic examination of surgical specimens. Tumor infiltration into the surrounding structures was classified as partial stromal, complete stromal, or parametrial. Tumor-cervical stroma and tumor-parametrium contrast-to-noise ratios (C/Ns) were higher (P < .05) at nonenhanced T2-weighted than at enhanced T1-weighted than at enhanced T1-weighted imaging. In determining the depth of invasion, the overall accuracy was 85% for nonenhanced T2-weighted and 57% (P < .05) for enhanced T1-weighted imaging. With conventional SE sequences, nonenhanced T2-weighted MR imaging is superior to contrast-enhanced T1-weighted MR imaging in determining the degree of invasiveness in clinical early-stage cervical tumors