Cancer of the cervix and endometrium on ultrasound
Ultrasound can identify early stage cancer of the uterus, including the cervix. This is because the tissue affected by the cancer process structure differ from normal. Besides, there is also a change in blood flow, which can be estimated using Doppler. Therefore, in order to see cancer in preclinical stages is required combined diagnostics using ultrasound (the most informative vaginal access) and Doppler.
Cancer of the endometrium (uterus) is a malignant tumor whose development is associated with hormonal disorders (excess estrogen or increased sensitivity of tissue receptors to these hormones).
To improve the accuracy obtained by this method results a simultaneous Doppler assessment of blood flow. Malignant cancer involves increased blood flow and blood vessels lose the resistance (tone them down), and also changes the direction of blood flow (turbulence appears). Therefore, all women in perimenopausal age 1 year are shown holding the Doppler. This study most significantly of all non-invasive methods of diagnosis can detect the PRECLINICAL stage of cervical cancer. If it shows abnormalities, it requires invasive methods of biopsy and histology. This approach is capable of defending a woman from a malignant process.
Now let’s touch on the ultrasound criteria for each form of endometrial cancer. Form of nodular ultrasound is characterized by the following criteria:
- Echo-positive education, which bulges into the uterine cavity.
- Its form is an irregular oval or rounded.
- Bumpy contours of the formation, except the walls, which is linked directly to the myometrium.
- The fuzzy outline of the Foundation of the pathological education.
- The interruption of the contour of the uterine lining (M-echo) in the place where the tumor.
Diffuse form of cancer in the uterus on ultrasound signs is divided into two subspecies:
- Diffuse-infiltrative – change of the uterine wall in which you receive a discontinuous contour, infiltration, shademot borders, etc.
In some cases, a single sonographic criterion that indicates cancer of the uterus, is of hematometra – accumulation of blood in the uterine cavity. But it could be the presence of seasonedly – accumulation of mucous fluid. In principle, using ultrasound to differentiate the nature of the liquid is difficult. It is important that it is there. If it finds such a pattern, there must be vigilance concerning the cancer process, especially when this picture is diagnosed in women in menopause. A more thorough study could detect the change of a wall or the presence of plus-tissue (or defect).
Currently, it is proved that the main reason develops cervical cancer is infection in women certain strains of HPV. He is able to change the genetic program of cells and transfer them to the stage of uncontrolled division, which is no stage differentiation. The result is the destruction of body defective cancer cells.
You can smell a rat with the help of transvaginal ultrasound. A very important diagnostic criterion for cervical cancer is the detection of so-called «pearl necklace». This is an early ultrasound marker of malignancy, i.e., malignant transformation of cells. He looks like a hyperechogenic formations, which have a rounded shape. They line up, resembling a string of pearls. If you find this symptom, it is required to conduct a histological study. The percentage of detection of malignant transformation of the cervix in this case is very large.
Ultrasound also can detect hypoechoic areas, which have a diameter less than 6 mm. They are also quite specific as an indication of the early stage cervical cancer. However, this symptom may be in other pathological processes in this area. That is, it is not specific, but require additional diagnostic search.
Doppler ultrasound can also provide valuable information in cases of suspected cervical cancer. To determine the degree of risk of this disease in women specific it is important to evaluate the following parameters:
- To study the course and the number of vessels in the neck.
- To measure the maximum blood velocity.
- To measure the maximum speed in the veins.
- To evaluate the resistance index.
In cancer, they change as follows (the data is average):
- Increased vascularization.
- Increases the speed of blood flow in veins and arteries.
- Reduced resistance index.
Therefore, all the patient at risk for development of cervical cancer it is necessary to conduct a transvaginal ultrasound in combination with Doppler ultrasound. But if possible, these two studies need to be performed every woman, even if she is not at risk. The frequency of their conduct – not less than 1 time per year.
Diagnostic tactics after the ultrasound
In cases where sonography reveals a deviation from the normal structure of the uterus, including her cervix showing holding of additional diagnostic tests. It is connected with oncological alertness that must be present for every doctor, especially if the patient refers to perimenopausal age. At this time, the risk of cardiovascular processes particularly raised.
Thus, studies that can and should be done for further diagnosis, are:
- Diagnostic dilatation and curettage.
- Determination of the level of cancer markers.
- Radiography and others.
However, the precise diagnosis can be established only after the study of the morphological structure of a single tissue sample. In Oncology it is considered the «gold» standard. Ultrasound is not 100% guarantee the absence or presence of cancerous lesions. With it, we can only assume the probability of a precancerous or cancerous condition.