Article Text

Thinning of preserved stromal cervical ring at magnetic resonance imaging in patients with early cervical cancer: a possible predictor of extracervical invasion
  1. F. Landoni,
  2. A. Pellegrino,
  3. G. Cormio*,
  4. G. Zanetta,
  5. A. Del Maschio,
  6. A. Vanzulli and
  7. C. Mangioni
  1. 3rd Clinica Ostetrica e Ginecologica—Istituto di Scienze Biomediche Ospedale S. Gerardo-Monza;†Istituto di Radiologia— Ospedale San Raffaele, Milano; and *Patologia Ostetrica e Ginecologica Università degli Studi di Bari, Italy
  1. Address for correspondence: Dr G. Cormio, Patologia Ostetrica e Ginecologica-Policlinico Piazza Garibaldi 60, 70054 Giovinazzo, Bari, Italy.


The sensitivity of magnetic resonance (MR) imaging in predicting extracervical tumor invasion on the basis of the detection of a thinning of the uninvolved cervical stromal ring (3 mm or less) was compared to the sensitivity achieved by visualization of a complete stromal interruption. Fifty-seven consecutive patients with squamous carcinoma of the uterine cervix (FIGO stage IB-IIA), scheduled for radical surgery, were examined with axial and sagittal weighted MR sequences. The sensitivity in predicting extracervical involvement on the basis of the MR imaging visualization of a thinned stroma was 87.5%, whereas the sensitivity obtained by detection of a complete stromal interruption was 70%. Among women with a spared cervical stroma of more than 3 mm at MR imaging, only two had microscopic extracervical involvement at pathologic examination, accounting for a negative predictive value of 92.8%. The results of our study show a high concordance between MR imaging and pathologic findings, and indicate that the detection of an intact cervical stromal ring exceeding 3 mm at MR imaging is related to a very low risk of extracervical seeding of tumor. On the other hand, the detection of a thinned stromal ring is related to a high incidence of microscopic parametrial invasion. The information obtained by this imaging technique may therefore be extremely useful in accurate treatment planning for these patients.

  • cervical cancer
  • magnetic resonance imaging
  • staging
  • uterine neoplasms

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