BLADDER AND RECTUM INFILTRATION IN CARCIN OMA OF THE UTERUS - ACCURACY OF CT AND MRI IN COMPARISON TO ENDOSCOPIC PROCEDURES

Purpose: To establish the value of computed tomography (CT) and magnet ic resonance imaging (MRI) in predicting bladder and rectum involvemen t in uterine carcinoma. Material and methods: 6 different imaging sign s (focal obliteration of perivesical or perirectal fat planes, area an d angle of contact between uterus and bladder or rectum, asymmetric bl adder or rectum wall thickening, evidence of intraluminal masses, and signal intensity of bladder or rectum wall on T-2-weighted or contrast -enhanced MR images) were analysed retrospectively in 129 patients who underwent 92 CT and/or 64 MRI examinations. The data were correlated with intraoperative findings and the results of cystoscopy and rectosc opy. Results: Asymmetric wall thickening, evidence of intraluminal mas ses and increased signal intensities of the bladder wall or rectum wal l were valuable signs of infiltration (sensitivity 71-100%, specificit y 91-96% and accuracy 89-97%). In 27 patients submitted to both imagin g examinations MRI was somewhat superior compared to CT (p>0.1) and yi elded similar results as endoscopic procedures (accuracy of cystoscopy and rectoscopy of 90% and 94%, respectively). Conclusion: CT and MRI allow to predict involvement of bladder or rectum wall in carcinoma of the uterus with a similar accuracy as endoscopic procedures.