MRI staging accuracy

Vaginal carcinoma is a rare tumour and there are no published series comparing MRI staging with either surgically resected specimens or clinical staging. MRI has better soft tissue discrimination than CT and is more sensitive in the detection of small tumours and in the identification of local invasion of the pelvic floor, perineum, urethra and anal canal. CT is a valid alternative to MRI in large tumours when assessment of bladder or rectal invasion is required.

Assessment of nodal status in pelvic malignancy is based on node size and shape, with nodes^ 10.0mm in maximum short axis diameter or with a round shape being more likely to be involved by tumour. Accuracies are similar for CT and MRI. Nodes showing central necrosis, manifest as central high signal on T2-weighted images or lack of enhancement following Gd-DTPA, are more likely to be metastatic.

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