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Uterine Cervical Carcinoma after Therapy: CT and MR Imaging Findings¹

¹ From the Department of Diagnostic Radiology, Chonnam National University Medical School, 8 Hack-Dong, Dong-Ku, Gwang-Ju 501-757, Korea. Recipient of a Certificate of Merit award for an education exhibit at the 2002 RSNA scientific assembly. Received January 2, 2003; revision requested January 24 and received February 21; accepted February 26. Address correspondence to Y.Y.J. (e-mail: yjeong@chonnam.ac.kr).

Cervical carcinoma is one of the most frequent causes of death in women. Computed tomography (CT) and magnetic resonance (MR) imaging are the primary modalities for follow-up of treated cervical carcinoma. A normal vaginal cuff after hysterectomy appears as a smooth, low-signal-intensity muscular wall on T2-weighted MR images. Early (2–3 months after treatment) and significant decreases in the signal intensity and volume of the tumor at MR imaging indicate a good response to radiation therapy. Sites of recurrence are the pelvis, lymph nodes, and distant sites. Pelvic recurrence appears as a heterogeneously enhancing mass at contrast material–enhanced CT and often appears as a heterogeneous, high-signal-intensity mass at T2-weighted MR imaging. Lymph node recurrence ranges from scattered, minimally enlarged nodes to large, conglomerate nodal masses. Determination of neoplastic infiltration of lymph nodes is based on size; most researchers consider nodes greater than 1 cm in short-axis diameter to be metastatic. Distant metastases are usually due to recurrent disease and occur in the abdomen, thorax, and bone. Knowledge of the normal therapeutic changes and the spectrum of recurrent tumor in patients with cervical carcinoma is important for accurate interpretation of follow-up CT and MR images.

© RSNA, 2003

Index Terms: Uterine neoplasms, 854.32 • Uterine neoplasms, CT, 854.1211 • Uterine neoplasms, diagnosis, 854.39 • Uterine neoplasms, metastases, _**.33² • Uterine neoplasms, MR, 854.1214 • Uterine neoplasms, therapeutic radiology, 854.47 • Uterine neoplasms, therapy, 854.451

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