Ressonancia magnetica resumida na avaliação da extensão do carcinoma de endometrio / Limited-sequences of magnetic resonance imaging in assessing the extent of endometrial carcinoma

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Background: Magnetic resonance imaging (MRI) is an exam that may be helpful in establishing presurgical staging of patients with endometrial carcinoma, allowing a more appropriate surgical procedure to be planned, principally in the case of advanced disease or in women with relevant clinical comorbidities. However, it is a protracted exam that requires cooperation and immobility. In addition, it is noisy and physical space is restricted, often causing discomfort, anxiety and claustrophobia that may lead to interruption of the exam. Movements including accentuated breathing may generate artifacts that compromise the quality of images. Simplifying the exam by reducing the time required to carry it out without affecting the quality of diagnosis would be extremely useful. Objectives: To evaluate whether modification to the routine MRI (complete MRI) by eliminating the non contrast high resolution sagittal T1-weighted FS and caronal T2-weighted TSE sequences (resumed MRI), negatively affects performance of this exam in the diagnosis of the extent of endometrial carcinoma. Methods: A cross sectional, observational, descriptive study was carried out in 62 women with endometrial carcinoma. All underwent pelvic MRI, which was analyzed by two radiologists. Complete and rapid MRI findings were compared with anatomopathology reports. The chi-square test was used to test the association between qualitative variables. Diagnostic agreement between complete and resumed MRI was analyzed using the kappa coefficient. Results: There were no statistically significant differences in the medians, means, standard deviations or maximum values of the measurements of the greatest diameter and of tumor volume as evaluated by complete MRI, resumed MRI and pathology. With respect to myometrial invasion, agreement between complete and resumed MRI was classified as very good, with a kappa coefficient of 0.73 (0.54 - 0.93). Agreement in the evaluation of myometrial invasion between pathology and complete or resumed MRI was classified as good. With respect to cervical invasion, agreement between complete and rapid MRI was classified as excellent, with a kappa coefficient of 0.96 (0.87 - 1.00). Agreement in the evaluation of cervical invasion between pathology and complete and resumed MRI was classified as very good. With respect to pelvic Iymph nodes, agreement between complete and resumed MRI was classified as excellent, with kappa coefficients of 0.93 (0.84 - 1.00) and 0.96 (0.90 - 1.00), respectively. Conclusions: MRI without the non-contrast sagittal T1-weighted SE and coronal T2-weighted TSE sequences maintains the same performance as complete MRI in evaluating the extent of endometrial carcinoma. The shorter time required to carry out the exam would, therefore, be beneficial to the patients, reducing their discomfort and, principally, decreasing reactions of anxiety and claustrophobia. Moreover, costs to healthcare services, and indirectly to the patients, would also be reduced, since the productivity of the equipment and the team would be higher.

ASSUNTO(S)

cancer do endometrio endometrial carcinoma imagem por ressonancia magnetica magnetic resonance imaging

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