[Value of CT scanning in the diagnosis of early cervical carcinoma].

OBJECTIVE: To investigate the value of CT scanning in preoperative diagnosis of early cervical carcinoma. METHODS: Abdominal and pelvic CT scans (MPR pictures for 50 patients) in 102 cervical carcinoma patients proven by biopsy pathology were retrospectively analyzed and compared with surgical pathologic findings. The pathological stages included > or = Ia in 39 patients, Ib 1 in 35, Ib 2 in 21, IIa in 6, IIb in 1. The tumor detection ability, thickness of cervical tumor invasion, T stage and lymph node stage showed by CT scan were evaluated. RESULTS: CT was not able to detect < or = Ia cervical carcinoma, however, CT was able to detect tumors in 71.4% of > or = Ib 1 stage (45/63) and 71.4% > or = Ib 2 (20/28), it also showed the depth of tumor invasion in 39.7% > or = Ib 1 (25/63). The overall accuracy of CT staging for tumor was 69.6% and the rate of metastatic lymph node detection 63.6% (7/11). With additional MPR pictures of spiral CT, the detection ability, vaginal involvement and objective shape of cervical tumor was improved. The cervical carcinoma in CT scan was found to be as homogeneous in 54.9% of patients (56/102), hypodense or heterogeneous in 42.2% (43/102), lower density nodual in 41.9% (18/43); occasionally as heterogeneous or hyperdensity noduals or irregular border of the cervix. The features of metastatic lymph nodes in CT scan were rounded or spheroid shape of soft tissue noduals with heterogeneous density caused by central necrosis and rim enhancement. CONCLUSION: CT scanning may be valuable in detection of > or = Ib 1 rather than < Ib 1 stage early cervical carcinoma. The additional MPR pictures of spiral CT is not only helpful in detecting tumor but also in determining the extension of cervical carcinoma.