Normal and abnormal MRI findings after abdominal radical trachelectomy (ART) for cervical cancer
Journal Title: Hellenic Journal of Radiology - Year 2016, Vol 1, Issue 1
Abstract
Purpose: To report MRI findings after abdominal radical trachelectomy (ART) for early-stage cervical cancer. Material and Methods: During an 8-year period, 25 women (mean age: 32 years) with biopsy-proven cervical cancer stage ≤IB1, were treated with ART. Postoperative MRI was performed in 22/25 patients, 6 months after ART and every 6 months thereafter, for a total of 6-48 months (mean: 24 months). Normal MRI features of utero-vaginal anastomosis and post-ART complications were recorded by two expert radiologists. Results: The utero-vaginal anastomosis was clearly depicted on all postoperative MRIs; a vaginal neo-fornix was observed in 17/22 patients. Magnetic susceptibility artefacts caused by the metallic cerclage suture placed at the anastomosis, were more prominent on gradient-echo sequences, partially degrading image quality. Baseline postoperative MRI showed diffuse vaginal wall thickening in 14/22 patients; this gradually resolved within a year from surgery. Asymptomatic lymphoceles occurred in 4/22 patients. Two/22 patients developed symptomatic isthmic stenosis and hematosalpinges, the first 2 years after surgery. In 4/22 patients, hydrosalpinges were discovered incidentally 6 months after ART; one of these patients was diagnosed with pelvic inflammatory disease a year after surgery. Follow-up MRI revealed local tumor relapse in two patients and nodal involvement in one patient, within 2 years after ART. Conclusion: Post-ART complications observed on MR images of the pelvis include: vaginal wall thickening, lymphoceles, isthmic stenosis, hemato/hydrosalpinges and tumor recurrence. Familiarization of radiologists with the post-ART MRI appearance of utero-vaginal anastomosis is important to avoid misdiagnosis of tumor recurrence.
Authors and Affiliations
Konstantinos Chatoupis, Charis Bourgioti, Aristeidis Antoniou, Evangelia Panourgias, Lia Angela Moulopoulos
Quadratus femoris muscle: spectrum of MR imaging findings in 51 patients presenting with painful hip
Purpose: To provide an overview of magnetic resonance (MR) imaging findings related to quadratus femoris muscle (QFm) pathologies in symptomatic patients. Material and Methods: MR imaging studies from 51 patients, who we...
Percutaneous transhepatic image-guided interventions for malignant biliary obstructions: Current status
A malignant biliary obstruction (MBO) occurs when there is a blockage of the bile outflow towards the duodenum due to a malignant tumour. The most common tumours that cause MBO with direct invasion of the biliary tree ar...
A 3-year old child with fever and disturbance of consciousness
A 3-year old girl presented to the emergency department withhighfever, irritability and moderate disturbance of consciousness. Laboratory tests did not show abnormal serum chemistry or inflammatory markers. Analysis of c...
Interventional Radiology - Growing into maturity
This issue of the Hellenic Journal of Radiology, which is enjoying a significant rejuvenation and an enhancement of its activities under the visionary editorship of Professor Nicholas Gourtsoyiannis, is dedicated to inte...
T2-weighted MRI findings predictive of parametrial involvement in patients with cervical cancer and histologically confirmed full thickness stromal invasion
Purpose: To record the T2-weighted imaging (T2WI) appearance of the cervical rim in cervical cancer patients with histologically confirmed full thickness stromal invasion and to identify any signs predictive of parametri...