MRI is the imaging method of choice for cervical disease, especially cervical cancer, including gynecology, and MRI is, arguably, the best imaging method.
MRI can directly observe tumor size, observe vaginal and parametrial invasion, show pelvic wall invasion, and observe intrapelvic lymph nodes. Its limitation is that it cannot distinguish stages before IB, and there may be false negatives and false positives for some stages IIB. In addition, enhanced scan is necessary when stage IVA is suspected.
Significance of MRI examination for cervical cancer
1.Discovering lesions, staging and deciding treatment plan
2.Preoperative evaluation of prognosis
3.Evaluate the efficacy after surgery or treatment
4.Discovering metastasis and recurrence
MRI examination methods
Scanning technique: sagittal, transverse
Scanning range: lower pole level of the left kidney to the perineal plane
Enhancement scan if needed
MRI manifestations of cervical cancer
1.Exophytic type: masses protruding outward to the cervix
2.Infiltrative type: infiltrative development along the endocervical lining and muscle layer
3.Intracervical type: swelling growth in the cervical canal
MRI staging points
ⅠB: The tumor does not show on MR or is confined to the cervical stroma, including stage 0, ⅠA and ⅠB
IIA: Normal low signal vaginal wall disappears
ⅡB: abnormal signal in the parametrial region with complete disappearance of low signal cervical stroma
ⅢA: ⅡA presentation extends to the lower 1/3 of the vagina
ⅢB: ⅡB extends to the pelvic wall or causes ureteral obstruction
ⅣA: disappearance of normal low-signal bladder or rectal wall, especially in sagittal T2WI images
Lymph node manifestation
>The lymph nodes are mostly located in the internal and external iliac cavity and can metastasize widely in the pelvic cavity and retroperitoneum, which is closely related to the size of the tumor.