Assessment of depth of myometrial invasion by endometrial carcinoma: comparison of T2-weighted SE and contrast-enhanced dynamic GRE MR imaging

A prospective study was undertaken to assess the value of both T2-weighted spin-echo (SE) and contrast-enhanced dynamic gradient-echo (GRE) sequences using MR imaging in differentiating the deep myometrial invasion from lower stages produced by endometrial carcinoma. For the correlation of MR findin...

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Bibliographic Details
Published in:European radiology 1998-01, Vol.8 (2), p.218-223
Main Authors: Savci, G, Ozyaman, T, Tutar, M, Bilgin, T, Erol, O, Tuncel, E
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Contrast Media
Endometrial Neoplasms - diagnosis
Endometrial Neoplasms - pathology
Female
Gadolinium DTPA
Humans
Magnetic Resonance Imaging - methods
Medical diagnosis
Middle Aged
Myometrium - pathology
Neoplasm Invasiveness
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
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Summary:A prospective study was undertaken to assess the value of both T2-weighted spin-echo (SE) and contrast-enhanced dynamic gradient-echo (GRE) sequences using MR imaging in differentiating the deep myometrial invasion from lower stages produced by endometrial carcinoma. For the correlation of MR findings with the histopathologic findings, patients who had no myometrial invasion (stage 1 a) and patients in whom tumors were confined to the superficial myometrium (stage 1 b) at pathologic examination were combined as lower stages. Twenty patients with endometrial carcinoma were studied using both techniques. The absence of any detectable tumor (stage 1 a) or the presence of a tumor confined to inner half of myometrium (stage 1 b) and extention of tumor to the outer half of myometrium (stage 1 c) were used as the diagnostic criteria. In pathologic examination of excised specimens, deep myometrial invasion was detected in 9 of 20 patients. The sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of T2-weighted SE in differentiating deep myometrial invasion from combined lower stages were 88, 91, 90, 88, and 91 %, respectively, whereas corresponding values for contrast-enhanced dynamic GRE sequences were 78, 100, 90, 100, and 85 %. Statistical difference between two sequences did not reach a significant level. We conclude that in cases of absence of visible junctional zone with SE sequence, contrast-enhanced dynamic GRE MR imaging may be helpful.
ISSN:0938-7994
1432-1084
DOI:10.1007/s003300050365