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919 Ultrasound role in staging of cancer cervix
  1. A Elagwany
  1. Alexandria university , Obg , Alexandria, Egypt


Introduction/Background*Cancer cervix is common in developing countries due to limited adoption of screening programs . It is far less common in Developed countries due to availability of national screening program and governmental health insurance system . Cancer cervix in developing countries usually present in stage 1b and beyond . MRI and EUA is usually used for staging before surgery .

Methodology Recently, due to advanced technologies in ultrasound , we can now stage cancer cervix accurately and replace MRI and EUA . We are trying here to spot the lights over this with a pictorial illustration of different stages. The accuracy of vaginal sonography for the evaluating cancer cervix is comparable to that of MRI and even better for local staging in identifying tissue planes

Result(s)*Ultrasound can be used in cancer cervix to assess the topography regarding exophytic versus endophytic tumor, The tumor size measured in three diameters and the distance between the tumor and the internal cervical os .the pericervical fascia which is the paracervix at he level of the cervix and the paracolpos at the level of the vagina is assessed . Thence, the extent of the radical procedure (parametrectomy) can be planned.

The tumor is usually hypoechoic in cases of squamous cell carcinoma and hyperechoic in adencarcinoma . His is important in differentiating large bulky endocervical tumors (with regular outline) (stage 1) from those with paramretrial invasion with irregular outline (stage 2 b) . The vaginal extension is evaluated by the thickening or masses of the vaginal walls (stage 2a) along with assessing the paracolpos in the same manner as before (stage 2b). Ureteral dilatation is common in parametrial infiltration and is seen .

The spread into the urinary bladder and/or rectum (stage 4) can be determined and the ultrasound for the bladder involvement is better than does cystoscopy, as this can only show bullous mucosal edema or mucosal lesion but not the wall affection that can be seen by ultrasound . The assessment of both is based on assessing her muscle layer and the related fascia.

Conclusion*Ultrasound is comparable to mri in local staging of cancer cervix especially for minor changes .

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