Ces radiol. 2009, 63(3):201-209

Recent trends in the imaging of gynaecological diseases with magnetic resonanceOriginal article

Boris Kreuzberg¹, Jan Kastner¹, Zdeněk Rokyta², Zdeněk Novotný², Petr Mukenšnábl³, Jiří Ferda¹

¹ Klinika zobrazovacích metod LF UK a FN, Plzeň

² Gynekologicko-porodnická klinika LF UK a FN, Plzeň

³ Šiklův patologicko-anatomický ústav LF UK a FN, Plzeň

Aim: The aim of the study was the retrospective evaluation of contemporary trends in the use of MRI of pelvis in gynaecological indications. Deeper analysis of the reliability of MR examinations especially oriented to staging was performed with regard to the prevalence of the diagnosis of uterine cervix carcinoma (the differentiation between T IIa and T IIb stages according to FIGO classification).

Method: Retrospective evaluation of the group of 114 women examined with 126 pelvic MR examinations. The evaluation of the frequency of various indications in the group. The group of patients has been examined in the years 2004-2008 on MR equipment Magnetom Avanto 1,5T Siemens according to the introduced protocol with the non-contrast and post-contrast sequences. The results of MRI were correlated with the results of operations, histological examinations, minority of cases with the course and findings during conservative therapy.

Results: According to the basic analysis of 126 examinations there was a concordance with the confirmed results in 95 examinations (75.5%), disagreement in 10 examinations (8%) and in 21 (16.5%) examinations we could't verify the findings. Next step of the analysis was oriented to all 46 cases with cervical carcinoma. In 8 cases there was a disagreement between MR examination and confirmed results (every patient was not operated on-advanced cases (T IIb and more advanced) were cured with actinochemotherapy. Finaly 31 patients with operated cervical carcinoma were analysed with regard to the reliability of the diagnosis of parametria infiltration. Resulting 50% sensitivity was deformed by the low number of the operated patiens with the infitration of parametria. Relatively high specificity 92.5% and negative predictive value (NPV) 92.5% together with the accuracy 87% were different in comparison with 50% positive predictive value (PPV), which was deformed from the same reasons.

Conclusion: Cervical carcinoma and endometriosis prevailed as the indications for MRI of pelvis. Introduced analysis demonstrates relatively high reliability of the examination. The problem with exact diagnosis of parametria infiltration continues. The experience of the other authors displays new attitudes for specifying of this diagnosis (dynamic MRI, diffusion weighted MRI).

Keywords: magnetic resonance, gynaecological indications of magnetic resonance, uterine cervical carcinoma, parametrial infiltration, endometriosis

Grants and funding:

Podpora výzkumného projektu MSM 0021620819.

Accepted: August 15, 2009; Published: September 1, 2009  Show citation