[Role of magnetic resonance imaging (MRI) in evaluation of the extension of endometrial carcinoma]

Abstract

The extent of endometrial carcinoma in Magnetic Resonance Imaging (MRI) was compared with that of histopathological findings. There was a significant positive correlation between the MRI values and the measured tissue specimen values for the minimum thickness of the residual myometrium (r = 0.8608; p less than 0.001). Twenty patients in the present study were divided into two groups according to myometrial invasion. Six patients (Group A) met the following criteria: (1) the area occupied by a high intensity lesion in the uterine body in the sagittal image is 50% or less, (2) the area occupied by a high intensity lesion in the uterine body in the transverse image is 50% or less, (3) the minimum thickness of the myometrium is 0.5 cm or more, and (4) the maximum-minimum ratio of myometrial thickness is 0.5 or more. Fourteen patients (Group B) did not meet these conditions. Myometrial invasion of carcinoma exceeding 1/3 of the myometrial thickness was not observed in any patient in Group A. A significantly greater percentage (86%) of Group B patients had myometrial invasion. Vessel permeation of carcinoma and metastasis was detected in 5 and 2 patients in Group B, respectively, but no patient in Group A had either vessel permeation or metastasis. A junctional zone was seen in 10 of 20 patients, and the carcinomatous lesions were limited to the endometrium in 2 patients, in which the junctional zone was not disrupted. In the other 8 patients, the localization of disruption of this zone corresponded to that of myometrial invasion. The sensitivity, specificity, and accuracy of MRI evaluation in the presence or absence of cervical involvement were 0.71, 0.92 and 0.85, respectively.