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Detection of parametrial invasion in cervical carcinoma: role of short tau inversion recovery sequence
1Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. wynnie@cuhk.edu.hk
Aim:
To investigate the role of short tau inversion recovery (STIR) sequence in the detection of parametrial invasion in patients with carcinoma of the cervix.
Materials And Methods:
Axial magnetic resonance imaging (MRI) images of the cervical region using T1 weighted turbo spin echo (TSE), TSE T2, STIR and T1 weighted dynamic gadolinium enhanced SE sequences were obtained in 38 patients with cervical carcinoma. All the images were assessed for the presence or absence of parametrial invasion using a standard scoring system. The diagnostic confidence, image quality, sensitivity, specificity, positive and negative predictive values and accuracy of each sequence were compared.
Results:
The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for each sequence in the diagnosis of parametrial invasion were: 60%, 80%, 32%, 93% and 78% for unenhanced T1W sequence; 90%, 92%, 64%, 98% and 92% for TSE T2 sequence; 90%, 94%, 69%, 98% and 93% for STIR sequence; and 90%, 80%, 41%, 98% and 82% for dynamic T1W sequence, respectively. Image quality and diagnostic confidence were both better for STIR and T2 compared to the dynamic T1 sequence.
Conclusion:
Dynamic T1W imaging is inferior to STIR and TSE T2 sequences. STIR is of similar value in the detection of parametrial invasion in cervical carcinoma as a TSE T2W sequence; their simultaneous use is not justified.