Pelvic imaging: multicystic uterine cervical lesions. Can magnetic resonance imaging differentiate benignancy from malignancy?

Purpose: To evaluate whether magnetic resonance imaging (MRI) can be used to differentiate between malignant and benign multicystic uterine cervical lesions. Material and Methods: Twenty-two patients with cervical adenocarcinomas, including minimal deviation adenocarcinoma, and five patients with benign multicystic lesions were classified as a percentage of solid components on MRI. Cystic components were further classified by average cyst diameter and signal intensity of the cyst fluid on T1WI. Results: All nine of the entirely solid lesions were malignant. In contrast, two of the entirely cystic lesions were benign. Ten of the ordinary adenocarcinomas had both solid and cystic components. However, three of the 16 solid and cystic lesions were benign. Lesions composed of cysts smaller than 5 mm tended to be malignant; however, some lesions composed of larger cysts were also malignant. Three of 5 lesions with low-signal and 7 of 10 with intermediate-signal fluid were malignant. Conclusion: The malignancy potential was higher in the lesions with a higher percentage of solid components. However, determining whether multicystic lesions were benign or malignant based on the existence of solid components, the average cyst size, and the signal intensity of cyst fluid was impossible. Although a multicystic lesion with solid components in the deep cervical stroma had been reported as a MR finding of a minimal deviation adenocarcinoma, this does not appear to be pathognomonic.