INVASION OF THE URINARY-BLADDER BY UTERINE CERVICAL-CARCINOMA - EVALUATION WITH MR-IMAGING

OBJECTIVE. This study was performed to assess the accuracy of MR imagi ng in revealing invasion of the urinary bladder by uterine cervical ca rcinoma. SUBJECTS AND METHODS. Vesical invasion was evaluated in 300 c onsecutive patients who underwent MR imaging for preoperative staging of uterine cervical carcinoma. MR imaging was obtained with a 0.5-T un it using spin-echo T1- and T2-weighted images. Contrast-enhanced T1-we ighted images were also obtained in 199 patients. MR imaging findings were compared with surgical or cystoscopic findings. MR images were th en reevaluated in all cases to detect any additional MR imaging findin gs suggestive of vesical invasion. RESULTS. Among the 300 patients, ve sical invasion was present in 12 patients. For detecting vesical invas ion, MR imaging had a sensitivity of 83%, a specificity of 100%, and a n accuracy of 99% (10 true-positives, 288 true-negatives, no false-pos itives, and two false-negatives). MR imaging findings that suggested v esical invasion were nodularity and irregularity of the bladder wan (n = 5), masses protruding into the bladder lumen (n = 2), and high sign al intensity of the anterior aspect of the posterior wall of the bladd er (n = 7). In addition, we saw abnormal soft-tissue strands in the ut erovesical space in the two false-negative cases. On reevaluation of t he MR images in the true-negative cases, we did not see nodularity or irregularity of the bladder wall, masses protruding into the bladder l umen, high signal intensity of the anterior aspect of the posterior wa ll of the bladder, or soft-tissue strands in the uterovesical space. C ONCLUSION. Familiarity with the MR imaging findings that we have descr ibed may prove helpful before surgery in detecting vesical invasion by cervical carcinoma.