자궁 경부암의 간질 침윤 깊이 평가에 있어서 역동적 자기공명영상 및 조영 증강 후 T1 강조 영상의 유용성

Abstract

Purpose : The purpose of this study was to evaluate the usefulness of contrast enhancement in assessing the depth of stromal invasion in patients with uterine cervical tumors by comparing dynamic and late contrast-enhancedT1-weighted MR imaging with T2-weighted MR imaging.Materials and Methods : Of 58 surgically proven uterine cervical cancer patients, 31 in whom tumors were seen on MRI were included in this study. Using a 1.5 T magnet, T2-weighted contrast-enhanced dynamic, and T1-weighted MR imaging were performed. In each MR imaging sequence, tumor visualization, margin delineation, enhancement pattern and depth of stromal invasion were evaluated on sagittal images and were correlated with pathological findings of resected uterus, focusing on the depth of stromal invasion. Results : Surgical FIGO stages were IB1 in 20 patients, IB2 in three, IIA in six, and IIB in two. A tumor was detected in 29 (94%) patients on T2-weighted images, in 26 (84%) on dynamic contrast enhanced images, and in 28 (90%) on contrast enhanced T1-weighted images. The tumor demonstrated a clear margin in 22 (71%)patients on late contrast-enhanced T1-weighted images, in 21 (68%) on dynamic images, and in 13 (42%) onT2-weighted images. Correlated with pathologic findings, the depth of stromal invasion was overestimated onT2-weighted images in eight (26%) patients, and on dynamic and late contrast-enhanced T1-weighted images in three (10%) and three (10%) respectively. Conclusion : Tumor margins are clearer and the extent of tumors may be more accurately evaluated on dynamic MR and late contrast-enhanced T1-weighted imaging. These sequences thus seem to be useful, and superior to T2-weighted imaging, for assessing the depth of stromal invasion in patients with cervical carcinoma.