Sandndox moco
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Pelvic MRI
A dedicated pelvic MRI protocol is recommended for optimal assessment.[1] MRI is considered superior to CT for local staging. Contrast enhanced MRI imaging improves accuracy in detecting myometrial invasion.
- T1: hypo- to isointense to normal endometrium
- T1 C+(Gd): carcinomatous tissue will enhance less than normal endometrium
- T2: hyperintense or heterogeneous relative to normal endometrium
MR Imaging findings according to FIGO stage
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- stage 1a: tumour confined to the uterine endometrium
- normal or widened endometrium
- normal low T2 signal junctional zone
- complete subendometrial enhancement on T1 contrast imaging
- stage 1b: invasion of less than half of the myometrium
- disruption or irregularity of the low T2 signal junctional zone
- disruption of subendometrial early enhancement
- stage 1c: invasion of outer half of myometrium
- disruption or irregularity of the low T2 signal junctional zone
- disruption of subendometrial early enhancement
- preservation of band of outer myometrium
- stage 2: tumour extends to cervix
- stage 2a
- widening of internal os and endocervical canal by high/isointense T2W signal tumour mass.
- intact low T2W signal of normal cervical stroma
- stage 2b
- widening of internal os and endocervical canal by high/isointense T2W signal tumour mass
- disruption of low T2 signal cervical stroma
- stage 3: tumour extension beyond the uterus
- stage 3a
- irregularity to the uterine contour
- disruption of low T2 signal uterine serosa
- stage 3b
- thickening of vaginal wall
- high T2 signal tumour infiltrating low signal vaginal wall
- stage 3c
- pelvic/para aortic lymph node involvement
- short axis >/= 8 mm in pelvic nodes
- stage 4: bladder/rectal or distant metastasis
- stage 4a
- disruption of low T2 signal bladder or rectal wall
- intraluminal bladder mass