Role of Diffusion Weighted MRI and Contrast Enhanced MRI in Diagnosis of Uterine Cervical Mass

Background: Cervical cancer is one the most frequently diagnosed malignant diseases in females, affecting approximately 16 out of 100 000 women. Diffusion-weighted (DW) MRI is a newly developed technique characterized by an apparent diffusion coefficient (ADC). The reason for this work was to investigate the role of DW and contrast enhanced MRI (CE) in diagnosis of uterine cervical mass to differentiate a benign from cancerous lesions.

Methods: This prospective study was done on 20 patients with uterine cervical masses. All patients were subjected to Personal, Past, Family history taking. Comprehensive clinical examinations Ultrasound: Previous pelvi-abdominal US, TVUS and Laboratory investigations including renal and liver functions and pregnancy test.

Results: The majority of patients (65%) had cervical masses in supravaginal portion while 35% had lesions in vaginal portion. The mean value of DWI findings was 0.88± 0.25. There was statistically significant increase in the size of mass in cases with malignant tumour compared to a benign one (p= 0.012). There was a significant increase in DWI findings in benign group compared to malignant group (p <0.001). The ROC curve showed that the best cut off of DWI was ≤ 0.9 with 100% specificity and sensitivity.

Conclusions: DWI could significantly predict patients with malignant lesion of uterine cervical mass at cut off value ≤ 0.9 with 100% accuracy, 100% sensitivity, 100% specificity, 100% PPV and 100% NPV.