ASSESSMENT OF DEPTH OF MYOMETRIAL INVASION BY ENDOMETRIAL CARCINOMA -COMPARISON OF T2-WEIGHTED SE AND CONTRAST-ENHANCED DYNAMIC GRE MR-IMAGING

A prospective study was undertaken to assess the value of both T2-weig hted spin-echo (SE) and contrast-enhanced dynamic gradient-echo (GRE) sequences using MR imaging in differentiating the deep myometrial inva sion from lower stages produced by endometrial carcinoma. For the corr elation of MR findings with the histopathologic findings, patients who had no myomotrial invasion (stage 1 a) and patients in whom tumors we re confined to the superficial myometrium (stage 1 b) at pathologic ex amination were combined as lower stages. Twenty patients with endometr ial carcinoma were studied using both techniques. The absence of any d etectable tumor (stage 1 a) or the presence of a tumor confined to inn er half of myometrium (stage 1 b) and extention of tumor to the outer half of myometrium (stage 1 c) were used as the diagnostic criteria. I n pathologic examination of excised specimens, deep myometrial invasio n was detected in 9 of 20 patients. The sensitivity, specificity, accu racy positive predictive values (PPV) and negative predictive values ( NPV) of T2-weighted SE in differentiating deep myometrial invasion fro m combined lower stages were 88, 91, 90, 88, and 91 %, respectively, w hereas corresponding values for contrast-enhanced dynamic GRE sequence s were 78, 100, 90, 100, and 85 %. Statistical difference between two sequences did not reach a significant level. We conclude that in cases of absence of visible junctional zone with SE sequence, contrast-enha nced dynamic GRE MR imaging may be helpful.