*Department of Obstetrics and Gynecology and †Paik Institute for Clinical Research, College of Medicine, Inje University, Busan Paik Hospital, Busan, Korea.
Int J Gynecol Cancer. 2013 Oct;23(8):1459-64. doi: 10.1097/IGC.0b013e3182a16997.
The aim of the study was to evaluate the feasibility of using 3-dimensional transvaginal ultrasound (3D-TVUS) to diagnose the extent of invasive cervical cancer.
Using 3D-TVUS, we prospectively examined 24 patients diagnosed with locally advanced invasive cervical cancer before primary surgery. Parametrial, vaginal, bladder, and rectal invasion, alongside cancer staging, was evaluated in the orthogonal planes. We compared the preoperative clinical, magnetic resonance imaging (MRI), and ultrasonography findings with the histological results from surgery.
With respect to cancer staging, accuracy was 62.5% with clinical examination, 40.9% with MRI, and 66.7% with TVUS. Magnetic resonance imaging demonstrated both low specificity (64.3%) and accuracy (68.2%) for nodal involvement. For the detection of parametrial invasion: sensitivity was 25% with clinical exanimation, 75% with MRI, and 75% with TVUS; specificity was 55.6% with MRI and 90% with TVUS; accuracy was 59% with MRI and 87.5% with TVUS. Although there was no case with bladder or rectal invasion, TVUS and MRI showed high specificity for the assessment of these. Clinical examination was useful for the detection of vaginal involvement.
Preoperative 3D-TVUS may prove to be an excellent method for the evaluation of locally advanced cervical cancer. Transvaginal ultrasound also has advantages over MRI for the assessment of tumor volume and Doppler velocimetry and is a low-cost alternative. However, TVUS cannot identify nodal or distant metastasis.
本研究旨在评估三维经阴道超声（3D-TVUS）诊断浸润性宫颈癌范围的可行性。
我们前瞻性地检查了 24 例经初步手术诊断为局部晚期浸润性宫颈癌的患者，使用 3D-TVUS 在正交平面上评估宫旁、阴道、膀胱和直肠侵犯情况以及癌症分期。我们将术前临床、磁共振成像（MRI）和超声检查结果与手术的组织学结果进行比较。
在癌症分期方面，临床检查的准确性为 62.5%，MRI 为 40.9%，TVUS 为 66.7%。MRI 对淋巴结受累的特异性（64.3%）和准确性（68.2%）均较低。对于宫旁侵犯的检测：临床检查的敏感性为 25%，MRI 为 75%，TVUS 为 75%；特异性为 MRI 为 55.6%，TVUS 为 90%；准确性为 MRI 为 59%，TVUS 为 87.5%。尽管没有膀胱或直肠侵犯的病例，但 TVUS 和 MRI 对这些部位的评估显示出较高的特异性。临床检查有助于阴道侵犯的检测。
术前 3D-TVUS 可能是评估局部晚期宫颈癌的一种极好方法。经阴道超声在评估肿瘤体积和多普勒流速方面优于 MRI，并且是一种低成本的替代方法。但是，TVUS 无法识别淋巴结或远处转移。
