Table 2 Features, advantages and disadvantage of different medical imaging methods on G-EAC

CT

Enlarged cervix comprising masses of low intensity, most of which are multiple complex cystic masses with smooth edges, and a few are solid masses with blurred edges

Enhanced CT could show the cystic lesions with enhanced contrast

Able to manifest the regional invasion and distant metastasis of the cervical lesion

Low soft-tissue contrast;

High radiation dosage;

Relatively low resolution of the solid component inside of the cervical mass;

MRI

Cosmos sign;

Barrel-like multicystic mass with hyper-intense in T2-weighted images, comprising solid components that grow from the cervical glands into the stroma, replacing the original fibromuscular cervical stroma

High soft-tissue contrast;

Able to exhibit the solid components inside of the cervical masses;

Capable of assessing the regional invasion of the cervical lesion

Relatively pricy and time-consuming;

Not suitable for patients with metal prosthetic, Implantable cardioverter-defibrillators (ICDs), or pacemaker, or end-stage renal disease:

Gray scale US and color doppler US

Enlarged cervix with multilocular cystic lesions, multilocular cystic lesions with solid components inside, or purely solid lesions;

Increased blood supply in the cystic septae between neighboring cysts or the solid component of the cervical mass under color doppler US

Non-invasive,inexpensive,and widely available;

Able to show the blood supply of the cervical lesion

Only able to show the sectional images and blood supply of the lesion rather than the overall morphology and blood supplies;

Unable to measure the volume,blood supply and vessel distribution of the lesion;

Incapable of distinguishing the solid invasive lesion from the normal cervical tissue,lower resolution in showing the invasion into the adjacent structure or distant metastasis of the cervical mass as compared with MRI and contrast enhanced-CT thus has limited diagnostic value

Multimodal US

3D realisticVue exhibited a distinctive “cosmos pattern”; blood flow histogram of the cervical mass shows increased VI, FI, and VFI values;

CEUS shows that the solid components inside of the cystic-solid mixed components of the cervical mass increased prior to the cervical myometrium, presenting a equal-high enhanced pattern.

Able to show the overall morphological structure,

Measure the volume, blood supply and vessel distribution of the cervical lesion;

Capable of quantifying the VI, FI, and VFI values of the blood supply of the cervical mass;

Capable of visualizing the potential solid components inside of the cystic components and quantifying the CEUS parameter of the solid components;

Able to assess the presence of invasion into the adjacent structure and distant metastasis;

Better capability of assessing the vaginal invasion than MRI

Time-consuming;

More expensive than oridinary US;

Worse than CT in finding distant metastasis