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

Keywords

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  • EP ID EP374080
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How To Cite

Konstantinos Chatoupis, Charis Bourgioti, Aristeidis Antoniou, Evangelia Panourgias, Lia Angela Moulopoulos (2016). Normal and abnormal MRI findings after abdominal radical trachelectomy (ART) for cervical cancer. Hellenic Journal of Radiology, 1(1), -. https://europub.co.uk./articles/-A-374080