[Uterine cervical carcinoma after radiotherapy: comparison between MR imaging and histopathological findings]

The findings of MRI and pathologic investigation were correlated in curatively irradiated uterine cervical carcinoma. Four patients having residual carcinoma diagnosed by biopsy underwent hysterectomy. MRI demonstrated the mass lesion in one patient with pathologic confirmation of massive viable cancer cells (case I). Of the other three patients, MRI demonstrated normal configuration of the uterine cervix. Cervical signal intensity, however, varied. Hyperintensity was noted in an area of the posterior wall on T2WI in case 2. The anterior wall of the case 2 and the other two cases showed hypointensity. Cervical specimens with normal intensity showed only a small number of degenerated cancer cells. On the other hand, pathologic examination of the posterior wall of the case 2 revealed both cancer cells with varying degrees of degeneration and necrotic tissues. Degeneration of cancer cells was stronger in the superficial layer than the deeper layer. Fibrosis, hemorrhage, granulation and hyalinization were hypointense on T2WI. T2 elongation reflected not only the residual tumor but the post-irradiation changes. Post-irradiated cervix with normal intensity indicated that only a small number of degenerated cancer cells may persist even if the biopsy was positive. We conclude that MRI is useful in evaluating tumor response to radiotherapy.