Carcinoma of the cervix: dynamic MR imaging

Dynamic magnetic resonance (MR) imaging was performed to evaluate eight normal uteri and 29 cervical carcinomas. After rapid injection of gadopentetate dimeglumine, dynamic images were obtained every 30 seconds with the spin-echo (SE) technique in the sagittal plane or the fast low-angle shot (FLASH) technique in the axial plane. In the normal uterus, initial slight enhancement of the junction between endometrium and myometrium was followed by enhancement of the uterine myometrium. Cervical carcinoma was readily distinguished from the cervical stroma and myometrium in the early dynamic phase (30-60 seconds). Tumor-cervix contrast in the early dynamic phase was significantly more marked with the dynamic SE technique than with T2-weighted or contrast material-enhanced T1-weighted imaging (P less than .01). For the evaluation of parametrial invasion, the dynamic FLASH study showed better contrast than did T2-weighted images. Among 18 patients who underwent surgery, accurate assessment of the degree of stromal invasion and tumor size was possible with dynamic MR images in 14 patients (78%), T2-weighted images in 11 (61%), and postcontrast T1-weighted images in seven (39%).