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Alexandria Journal of Medicine

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The Diagnostic accuracy of transvaginal ultrasonography, magnetic resonance imaging and diffusion weighted image in female patients with endometrial carcinoma

Dina Moghazy Mohamed, Khaled Abd El-Wahab abo Dewan, Salwa Mahmoud Mera

Abstract


Aim of work: To evaluate the efficacy of transvaginal ultrasonography (TVUS), magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) in presurgical staging of endometrial cancer.

Methodology: This work included 35 female patients. Thirty patients were diagnosed to have endometrial carcinoma.

Results: The sensitivity, specificity, predictive values, accuracy of transvaginal ultrasound in detection of invasion of myometrial cavity were 67.25%, 75.0%, 90.00%, 30.00% and in distant metastasis were 77.78%, 80.95%, 63.64%, 89.47% and %80. These variables for MRI were 88.89%, 100.0%, 100%, 66.67% and 91% in myometrial invasion and in distant metastasis were 100.0%, 100.0%, 100.0%, 100% and 100.0%. There was an inversely proportional relationship between ADC values and the tumor grading. Apparent diffusion coefficient (ADC) magnitude of 0.77 ± 0.21 x 10-3 mm2/s was associated with endometrial cancer while normal endometrial cavity showed ADC value of 1.31 ± 0.11 x 10-3 mm2/s).

Conclusion: Conventional MRI, diffusion weighted imaging and contrast enhanced MR images are superior to TVUS in patients with endometrial cancer and ADC values help to differentiate between normal and endometrial cancer which may replace MR contrast enhanced images.

Keywords: Transvaginal ultrasound, MRI, DWI, Endometrial carcinoma




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