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4 - Pathology of the uterus, cervix and vagina

Published online by Cambridge University Press:  04 March 2010

By
Josephine M. McHugo
Edited by
Jane Bates
Josephine M. McHugo
Affiliation:
Birmingham Women's Hospital, Birmingham
Jane Bates
Affiliation:
St James's University Hospital, Leeds
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Summary

Introduction

Ultrasound is the appropriate first investigation for the majority of pelvic symptoms in the female. It is however very operator-dependent and when used by appropriately trained personnel with appropriate equipment is cost-effective and safe. Transvaginal scanning is essential to increase the diagnostic accuracy of ultrasound and should be used in all cases unless there is a specific contraindication, such as in the paediatric population. It is essential that transabdominal ultrasound is also performed in order that the large fibroid uterus or other masses can be fully assessed in addition to imaging transvaginally.

There is a need for a meticulous approach to scanning in all cases so that significant pathology is not missed. The sonographer, having completed the ultrasound examination, must then issue an appropriate report. A structured report is also an essential part of the examination and should not only include the biographical details of the patient but also the salient ultrasound findings, both normal and abnormal, followed by either a definite diagnosis if this is possible, or a differential diagnosis.

Further investigations or definitive management can then be arranged.

The sonographer performing the examination should be clearly identified in the report.

A report that is structured in this way will allow retrospective audit of the ultrasound findings relative to operative findings and histology. This audit of accuracy of the ultrasound to histological outcome is essential for best practice.

Type
Chapter
Information
Practical Gynaecological Ultrasound , pp. 54 - 78
Publisher: Cambridge University Press
Print publication year: 2006

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References

Hasan, F., Arumugam, K. and Sivanesaratnam, V., Uterine leiomyomota in pregnancy. International Journal of Gynaecology and Obstetrics, 34 (1991), 45–8.CrossRefGoogle ScholarPubMed
Pelsang, R. E., Sorosky, J. and Woods, T., Sonographic evaluation of the broad ligament of the uterus. Journal of Clinical Ultrasound, 27 (1999), 402–4.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Christopherson, W. M., Williamson, E. O. and Gray, L. O., Leiomyosarcoma of the uterus. Cancer, 29 (1972), 1512–17.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Shapeero, L. G. and Hrick, H., Mixed Müllerian sarcoma of the uterus: MR imaging findings. American Journal of Radiology, 153 (1989), 317–19.Google ScholarPubMed
Kim, S. H., Hwang, H. Y. and Choi, B. I., Case report: uterine metastasis from stomach cancer: radiological findings. Clinical Radiology, 42 (1990), 285–6.CrossRefGoogle ScholarPubMed
Malatsky, A., Reuter, K. L. and Woda, B., Sonographic findings in primary uterine cervical lymphoma. Journal of Clinical Ultrasound, 19 (1991), 62–4.CrossRefGoogle Scholar
Su, W. H., Wang, P. H., Chang, S. P. and Su, M. C., Preoperative diagnosis of uterine lipoleiomyomata using ultrasound and computed tomography a case report. European Journal of Gynaecology and Oncology, 22 (2001), 439–40.Google Scholar
Gupta, J. K., Chien, P. F. W., Voit, D.et al., Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta analysis. Acta Obstetrica Gynecologica Scandinavica, 81 (2002), 799–816.CrossRefGoogle ScholarPubMed
Epstein, E. and Valentin, L., Managing women with post menopausal bleeding. Best Practice in Research Clinic in Obstetrics and Gynaecology, 18 (2004), 125–43.CrossRefGoogle ScholarPubMed
Scottish Intercollegiate Guidelines Network Investigation of Post-menopausal Bleeding (2002).
American College of Obstetrics and Gynecologist Technology Assessment, Saline infusion sonography. Journal of Gynaecology and Obstetrics, 84 (2004), 95–8.
Dubinsky, T. J., Stroehlein, K., Abu-ghazzeh, Y., Parvey, H. R. and Maklad, N., Prediction of benign and malignant disease: hysterosonographic-pathologic correlation. Radiology, 210 (1999), 393–7.CrossRefGoogle ScholarPubMed
Laifer-Narin, S., Ragavendra, N., Parmenter, E. K. and Grant, E. G., False-normal appearance of the endometrium on conventional transvaginal sonography: comparison with saline hyterosonography. American Journal of Roentgenology, 178 (2002), 129–33.CrossRefGoogle Scholar
Darwish, A. M., Makhlouf, A. M., Youssof, A. A. and Gadalla, H. A., Hysteroscopic myometrial biopsy in unexplained abnormal uterine bleeding. European Journal of Obstetrics, Gynecology and Reproductive Biology, 86 (1999), 139–43.CrossRefGoogle ScholarPubMed
Anderson, M. C., Butler, E. B. and Chamberlain, G. V. P., Oestrogen replacement and endometrial cancer. A statement by the British Cancer Group, Lancet, I (1981), 1359–60.Google Scholar
Rutqvist, L. E., Johansson, H., Signomklao, T.et al., Adjuvant tamoxifen therapy for early stage breast cancer and second primary malignancies. Journal of the National Cancer Institute, 87 (1995), 645–51.CrossRefGoogle ScholarPubMed
Ayiomamitis, A., The epidemiology of cancer of the uterine corpus in Canada 1950–85. International Journal of Gynaecology and Obstetrics, 27 (1988), 205–11.CrossRefGoogle Scholar
Berliere, M., Charles, A., Galant, C. and Donnez, J., Uterine side effects of tamoxifen: a need for systematic pretreatment screening. Obstetrics and Gynaecology, 91 (1998), 40–4.CrossRefGoogle ScholarPubMed
Cecchini, S., Ciatto, S., Bonardi, R.et al., Risk of endometrial cancer in breast cancer patients under long term adjuvant treatment with Tamoxifen. Tumori, 84 (1998), 21–3.CrossRefGoogle ScholarPubMed
Muylder, X., Neven, P., Somer, M.et al., Endometrial lesions in patients undergoing tamoxifen therapy. International Journal of Gynecology and Obstetrics, 36 (1991), 127–30.CrossRefGoogle ScholarPubMed
Hann, L. E., Kim, C. M., Gonen, M.et al., Sonohysterography compared with endometrial biopsy for evaluation of endoemtrium in tamoxifen treated women. Obstetrics and Gynaecology Survey, 59 (2004), 440–1.CrossRefGoogle Scholar
Sebire, N. J., Makrydimaas, G., Agnantis, N. J., Zagorianakou, N. and Rees, H., Updated diagnostic criteria for partial and complete hydatidiform mole in early pregnancy. Anticancer Research, 23 (2003), 1723–8.Google ScholarPubMed
Hancock, B. W. and Tidy, J. A., Current management of molar pregnancy. Journal of Reproductive Medicine, 47 (2002), 347–54.Google ScholarPubMed
Savelli, L., Pilu, G., Valeri, B. and Bovicelli, L., Transvaginal sonographic appearances of anaerobic endometris. Ultrasound in Obstetrics and Gynaecology, 21 (2003), 624–5.CrossRefGoogle Scholar
Devlieger, R., D'Hoogle, T. and Timmerman, D., Uterine adenomyosis in the infertility clinic. Human Reproduction Update, 9 (2003), 139–47.CrossRefGoogle ScholarPubMed
Confino, E., Friberg, J., Giglia, R. V. and Fleicher, N., Sonographic imaging of intrauterine adhesions. Obstetrics and Gynecology, 66 (1985), 596–8.Google ScholarPubMed
Cobby, M., Browning, J., Jones, A., Whipp, E. and Goddard, P., Magnetic resonance imaging, computed tomography and endosonography in the local staging of carcinoma of the cervix. British Journal of Radiology, 63 (1990), 673–9.CrossRefGoogle ScholarPubMed
Scanlon, K. A., Pozniak, M. A., Fagerholm, M. and Shapiro, S., Value of transperineal sonography in the assessment of vaginal atresia. American Journal of Roentgenology, 154 (1990), 545–8.CrossRefGoogle Scholar
Salim, R., Woelfer, B., Backos, M., Regan, L. and Jurkovic, D., Reproducibility of three dimensional ultrasound diagnosis of congenital uterine anomalies. Ultrasound in Obstetrics and Gynecology, 21 (2003), 578–82.CrossRefGoogle ScholarPubMed
Anderson, J., Gynaecologic Imaging (Churchill Livingstone, 1999).Google Scholar
Robby, S., Anderson, M. C. and Russell, P., Pathology of the Female Reproductive Tract (Churchill Liuingstone, 2002).Google Scholar
Fleischer, A. C., Manning, F. A., Jeanty, P. and Romero, R., Sonography in Obstetric and Gynaecology (Prentice Hall International)

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