**2.3.1.3 Cervical invasion**

58 Cancer of the Uterine Endometrium – Advances and Controversies

MRI was performed using GE 1.5T Signa HD Echospeed Superconducting Scanner with body phased-array. Intrauterine device was removed from each patient who had it and all patients were asked to drink about 500 ml water to make the bladder moderate full 1 h before the scanning. Conventional MRI was first performed with the sequences of SE T1 weighted imaging (T1WI) and fat-suppressed FSE T2-weighted imaging (T2WI). DCE-MRI was then performed in 9 patients with horizontal surface fast spoiled gradient echo (FSPGR) sequence and in 15 patients with sagittal liver volume T1-weighted ultra-fast threedimensional imaging (liver acquisition with volume acceleration, LAVA). MR scanning ranged from the upper edge of the iliac wing to the level of bilateral femoral neck with patients in the supine position. For DCE-MRI, Gd-DTPA contrast agent (0.1 mmol/kg) was given to each patient through antecubital vein using a high-pressure syringe with a flow rate of 2.5 ml/s. Scanning was taken at 16, 32, 48, 64, and 300 seconds (s), respectively, after

Two types were classified: diffuse type and focal type. Diffuse type was defined as extensive thickening of the uterine endometrium (>3 mm for menopause and >10 mm for premenopausal patients). The focal type was defined as the formation of soft-tissue mass.

Two groups were divided. One group referred to the tumors with no myometrial invasion (intact junctional zone and homogeneous low signal on T2WI) or with superficial myometrial invasion (depth of the myometrial invasion, ≤1/2). Another group referred to

Note: FSPGR: fast spoiled gradient echo sequence; LAVA: liver volume three-dimensional ultra-fast

the tumors with deep myometrial invasion (myometrial invasion, >1/2).

injection. The scanning parameters were summarized in Table 1.

**2.3.1 Analysis of the tumor characteristics** 

**2.2 MRI techniques** 

**2.3 Image analysis** 

**2.3.1.1 General types** 

**2.3.1.2 Invasion depth** 

T1WI sequence.

Table 1. The sequence parameters of MRI.

All tumors were divided into two groups: without cervical invasion and with cervical invasion.

#### **2.3.1.4 Infiltration width**

Tumors were classified into two groups. One group was the lesions limited within the uterus, and another group was those with invasion into the parametrium or adjacent organs, or with metastasis.
