The evaluation of transrectal radial ultrasonography on parametrial infiltration in untreated cervical carcinoma for more accurate staging.

To assess the diagnostic criteria of transrectal radial ultrasonography to differentiate a cervical carcinoma confined to the cervix from a lesion that invades the parametria, data on 41 patients with newly diagnosed, untreated cervical carcinoma were studied following transrectal ultrasonography (TRU). TRU findings associated with parametrial tumor invasion were: (1) Irregular margin of the cervix, (2) Parametrial thickness, (3) High dense echo, (4) Massive echo pattern. We prepared the TRU score with regard to characteristic findings. The TRU findings for eighty-two parametria in 41 patients with cervical carcinoma were compared with CT findings, surgical and/or clinical findings. Discrepancies were found between FIGO stages and the extent of the disease, in those in stage IIb. Among 32 parametria in the clinical stage IIb, only 17 parametria (53%) were correctly staged. Our diagnostic criteria for a high TRU score (more than 5) were the high significance of true parametrial infiltration in comparison with CT staging and clinical FIGO staging (Sensitivity was 83%, specificity 97%, positive predictive value 89% and negative predictive value 95%).