Abstract: Objective The objective of this study was to investigate the application value of multimodal MRI in evaluating parauterine invasion of stage IB1-IIA2 cervical cancer. Methods The multimodal MRI examination and postoperative pathological data of 106 patients with cervical cancer who underwent radical hysterectomy in Shaanxi Provincial People's hospital from August 2015 and April 2021 were collected.Two groups of MRI status were performed by two experienced physicians to evaluate the parauterine infiltration of the imaging data. Results Parauterine invasion was found in 28 of 106 patients(26.4%).In the plain MRI group,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of physician 1 in diagnosing parauterine invasion were 71.4%,84.6%,62.5%,89.2% and 81.1%,respectively.The corresponding rates of physician 2 were 67.9%,79.5%,54.3%,87.3% and 76.4%,respectively;the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of physician 1 in the diagnosis of parauterine invasion in the multimodal MRI group were 85.7%,98.7%,96.0%,95.1% and 95.3%,and the corresponding results for physician 2 were 89.3%,97.4%,92.6%,96.2% and 95.3%,respectively.The judgment of parauterine invasion by two physicians using multimodal MRI was better than that of single plain scan,and the specificity,positive predictive value and diagnostic accuracy were statistically different(P＜0.05).There was a high degree of agreement(κ=0.790)in the examination to assess the consistency of parauterine invasion,which was better than moderate agreement(κ=0.410)for plain scans. Conclusion Compared with conventional plain MRI,multimodal MRI can significantly improve the diagnostic accuracy of parauterine invasion in stage IB1-IIA2 cervical cancer,and can be used as a routine and effective method for judging parauterine invasion of cervical cancer.

Key words: Cervical cancer, Magnetic resonance imaging, Parauterine invasion