Bernaschek G
II. Universitäts-Frauenklinik Wien.
Ultraschall Med. 1987 Aug;8(4):160-5. doi: 10.1055/s-2007-1011685.
Endosonography offers two major advantages in the pretherapeutic examinations of a histologically verified carcinoma of the uterus. Endosonography allows (1) an overview of the size and location of the tumour and (2) an evaluation of the spreading and/or involvement of adjacent organs. Both add up to a more objective staging of the tumour and, therefore, may cause a more effective therapeutic approach. Especially in cases with endometrial carcinoma the uterine walls can be visualized either by the well-tolerated method of vaginosonography or by hysterosonography which can be performed only in general anaesthesia. Applying either endosonographical method, the infiltration depth of the myometrium and/or involvement of the cervix can be determined, which seems to be very valuable, particularly when differentiating between stages I and II. Rectosonography, with its transversal scanning probes, offers the advantage of demonstrating the infiltration of a cervical tumour into the parametrium. Here again, the benefit is seen in a more objective evaluation of tumour size and extension. However, tumour growth into the urinary bladder is best shown by cystosongraphy. With this method one cannot only have a view of the epithelium (as in cystoscopy) but one is also able to evaluate the underlying layers of the bladder wall. This seems to be an advantage in findings of a bullous oedema. Once again, rectosonography is advantageous in enhancing the diagnosis of recurrences of malignant tumours in the pelvic region. Like a prolongation of the palpating finger rectosonography is able to depict less echogenic areas located high up on the pelvic wall as local recurrences or tumours.(ABSTRACT TRUNCATED AT 250 WORDS)
在组织学确诊的子宫癌的治疗前检查中,内镜超声检查具有两大优势。内镜超声检查能够(1)全面了解肿瘤的大小和位置,(2)评估相邻器官的扩散和/或受累情况。这两者共同构成了对肿瘤更客观的分期,因此可能会带来更有效的治疗方法。特别是对于子宫内膜癌病例,子宫壁可通过耐受性良好的阴道超声检查方法或仅在全身麻醉下进行的子宫超声检查来可视化。应用任何一种内镜超声检查方法,都可以确定肌层的浸润深度和/或宫颈的受累情况,这似乎非常有价值,尤其是在区分I期和II期时。直肠超声检查及其横向扫描探头具有显示宫颈肿瘤向子宫旁组织浸润的优势。同样,其益处在于对肿瘤大小和范围进行更客观的评估。然而,膀胱内的肿瘤生长情况通过膀胱超声检查显示最佳。通过这种方法,不仅可以看到上皮(如同膀胱镜检查),还能够评估膀胱壁的下层。这在发现大疱性水肿时似乎是一个优势。再次强调,直肠超声检查在增强盆腔区域恶性肿瘤复发的诊断方面具有优势。就像触诊手指的延伸一样,直肠超声检查能够将位于盆腔壁高处的低回声区域描绘为局部复发或肿瘤。(摘要截断于250字)