MR Imaging of Carcinoma of the Vulva
S. A. Aslam Sohaib1,2,
Polly S. Richards1,
Thomas Ind2,
Arjun R. Jeyarajah3,
John H. Shepherd3,
Ian J. Jacobs3 and
Rodney H. Reznek1
1
Department of Diagnostic Imaging, St. Bartholomew's Hospital, West Smithfield,
London, EC1A 7BE, United Kingdom.
2
Present address: Academic Department of Diagnostic Radiology, Royal Marsden
Hospital, Downs Rd., Sutton Surrey SM2 5PT, United Kingdom.
3
Department of Gynaecological Oncology, St. Bartholomew's Hospital, West
Smithfield, London, EC1A 7BE, United Kingdom.

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Fig. 1. 75-year-old woman with carcinoma of vulva that measured 3
x 2 cm with less than 2-mm depth of invasion that was not visualized on
MR imaging. Axial T2-weighted fast spin-echo MR image fails to show tumor.
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Fig. 2. 21-year-old woman with carcinoma of vulva. Axial T2-weighted
fast spin-echo MR image shows 3-cm tumor (arrow) arising from right
labia.
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Fig. 3. 75-year-old woman with large central carcinoma of vulva
(straight arrow) involving clitoris (curved arrow). Axial
T2-weighted fast spin-echo MR image shows intermediate-signal-intensity tumor
extending to involve clitoris.
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Fig. 4. 75-year-old woman with carcinoma of vulva with left
superficial inguinal lymph node metastases. Axial T2-weighted fast spin-echo
MR image shows enlarged left superficial inguinal lymph node
(arrow).
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Fig. 5. 58-year-old woman with carcinoma of vulva and bilateral
femoral node metastases. Axial T2-weighted fast spin-echo MR image shows
bilateral 8-mm femoral lymph nodes (arrows).
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Fig. 6. Scatter diagram shows relationship between size of lymph
nodes (short-axis diameter) in benign and malignant nodes for inguinal and
femoral groups of nodes. Note that although malignant nodes are larger, there
is considerable overlap in size between benign and malignant lymph nodes.
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Fig. 7. Receiver operating characteristic curve shows relationship
between sensitivity and specificity for deep (femoral, ) and
superficial (inguinal, ) nodes at different size (short-axis diameter)
threshold criteria. Note that using size as criterion for malignant nodes
results in high specificity but poor sensitivity.
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Copyright © 2002 by the American Roentgen Ray Society.