Evaluation of MRI findings in detection of early stage cervical carcinoma of the uterus *
The purpose of this study was to assess the accuracy of magnetic resonance imaging（MRI）in early stage cervical carcinoma of the uterus. MRI findings and pathological findings were compared in 128 patients with cervical carcinomas in situ（n＝90）, early invasive stage Ia carcinoma（n＝19）, or stage Ib1 carcinoma（n＝19）, and their sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were assessed in terms of depth of invasion. These values were compared between a gynecologist and a radiologist, and those between 1.0T and 1.5T MRI were also compared, but there were no differences. The accuracy of T2WI in differentiating between non-invasive and invasive lesions was 0.742, and that of Dynamic MRI was 0.823. The accuracy of T2WI in differentiating non-invasive and invasive lesions ≦ 3mm from invasive lesions ＞ 3 mm was 0.875, while that of Dynamic MRI was 0.947. The accuracy in differentiating between lesions ≦ 5mm and ones ＞ 5mm was 0.953 for T2WI and 0.976 for Dynamic MRI. When patients（n＝11）were diagnosed as having an invasive lesion ＞ 5mm by both T2WI and Dynamic MRI, all were found to have invasive carcinoma ＞ 5mm. When patients（n＝73）were diagnosed as having a non-invasive lesion by both T2WI and Dynamic MRI, none were found to having an invasive lesion ＞ 5mm. Two of three patients who were diagnosed as not having an invasive lesion ＞ 5mm by T2WI but who were diagnosed as having one by Dynamic MRI had pathologically invasive carcinoma ＞ 5mm, indicating that Dynamic MRI might compensate for the false negative findings of T2WI. Among the 26 patients who were diagnosed as having microinvasive carcinoma ≦ 5mm by T2WI, 17 had non-invasive lesions. Twelve of these 17 patients were diagnosed as having non-invasive lesion by Dynamic MRI, suggesting that Dynamic MRI could compensate for the false positive findings of T2WI in microinvasive carcinoma. In conclusion, the combination of T2WI and Dynamic MRI can be a useful non-invasive diagnostic measure for the diagnosis of early stage carcinoma of the uterus. (Accepted on March 10，2004)
