Assessment of uterine enhancement rate after abdominal radical trachelectomy using dynamic contrast-enhanced magnetic resonance imaging

Arch Gynecol Obstet. 2016 Mar;293(3):625-32. doi: 10.1007/s00404-015-3842-7. Epub 2015 Aug 18.

Abstract

Purpose: The purpose of this study was to assess uterine enhancement rate after abdominal radical trachelectomy (ART) using dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging.

Methods: Ten patients with early uterine cervical cancer, who were treated by ART, were included in this study. Each patient underwent DCE MR imaging using a 3 T unit to assess uterine enhancement rate at three times (before surgery and 1 and 3 months after surgery). The radiologist calculated mean signal intensities of the anterior and posterior myometrium and also measured the signal intensities of the urine in the bladder on the same image, which was expressed as the myometrium-to-urine signal intensity ratio. In the time-intensity ratio curve, enhancement parameters (peak signal intensity ratio and peak time) of the uterine body were compared across the three MR examinations.

Results: The peak signal intensity ratio was 6.96 ± 0.98 on MR examinations before surgery, 6.14 ± 0.81 1 month after surgery, and 6.26 ± 0.63 3 months after surgery (p = 0.069). The peak time was 57.6 ± 3.4 s on MR examinations before surgery, 56.4 ± 4.4 s 1 month after surgery, and 53.2 ± 8.0 s 3 months after surgery (p = 0.304). No significant differences were found in either the peak signal intensity ratio or peak time across the three MR examinations.

Conclusions: That no significant decrease of uterine enhancement rate was found after surgery suggests the uterine function and fertility may be preserved after ART.

Keywords: Cervical cancer; Magnetic resonance imaging; Trachelectomy.

MeSH terms

  • Abdomen / pathology
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Cervix Uteri / blood supply*
  • Cervix Uteri / surgery
  • Contrast Media
  • Female
  • Fertility Preservation
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Myometrium / pathology
  • Trachelectomy*
  • Uterine Artery
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*

Substances

  • Contrast Media