Ultrasonography in assessing the cervical cancer extent

Abstract

Aim. To study the potentials of complex ultrasonography in assessing the extent of cervical cancer, defining typical ultrasonographic features of cervical cancer. Methods. 75 patients with the diagnosis of morphologically confirmed cervical cancer were examined. Continuous sampling method was used to recruit the patients. Patients underwent transabdominal, transvaginal and transrectal ultrasonography with the use of color Doppler and power Doppler modes. Results. 57 (76,5%) patients were diagnosed with squamous cell non-keratinous carcinoma, 12 (16%) - with squamous cell keratinous carcinoma, 6 (8%) - with adenocarcinoma. 43 (57,3%) patients had cancer stages I-II, 32 (42,7%) - cancer stages III-IV. The certain features of ultrasonographic images were found at different stages of cervical cancer. At cancer stage I the most typical findings were: low echogenicity area, diffuse heterogeneity of stroma, area of hypervascularity at the place of cervical cancer. Increased blood flow at the cancer site is typical for cervical cancer because of tumor vasculature hyperplasia and neoangiogenesis, the increase in number of blood vessels is proportional to tumor size. Cervix hypertrophy, fuzzy and irregular contouring, no flexion angle between the fundus and cervix were characteristic for cervical cancer stages II-III. Corpus uteri echo-structure at the tumor site portrays the tumor structure. Infiltrates in parametrium can be seen. At stage IV tumor spreads to urine bladder and rectum walls. In advanced stages uretеrs can be involved, pyelectasis and ureterectasis can develop. Conclusion. Complex ultrasonography allows to diagnose cervical cancer quite reliably and to estimate the extent of cervical cancer.