MR imaging and transrectal US in the evaluation of stage I-II cervical carcinoma

Twenty-five patients with histologically-proven cervical carcinoma (clinical stages I and II according to FIGO classification system) were studied by means of transrectal US (TRUS) and MR imaging (MRI) at 1.5 T, to evaluate the primary tumor and measure its size. Stage Ib cancers were divided into small (<4 cm) and large (>4 cm). The patients with large Ib and those with stage II lesions were administred preoperative radiation therapy: All the patients underwent TRUS, MRI and clinical examination under sedation; they were subsequentially operated. Stage Ia and small Ib patients underwent therapeutic surgery, while large Ib and stage II cases had surgical exploration for pathologic staging. The tumor was correctly identified and measured in 22 patients with MRI, and in 20 cases with TRUS. Tumoral involvement of parametria and uterine ligaments was demonstrated in 75% of cases by MRI and in 62.5% of patients by TRUS. Vaginal involvement was demonstrated by MRI in 77.8% of cases and by TRUS in 66.6% of patients. Tumor size could be evaluated more accurately tahn with clinical examination under sedation, while the results were poorer in the demonstration of tumor spread into uterus and parametria