الفهرس 
Normal Anatomy of the Female UterusOnly 14 pages are availabe for public view
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Abstract
Ultrasonography, whether transabdominal or endovaginal, relies on morphologic assessment of the tumor to distinguish between benign and malignant disease. Morphologic features including thick, irregular walls and septa, papillary projections, and solid, moderately echogenic loculi have been described as suggestive of malignant tumor while in the evaluation of pelvic physiology and pathology in the female, Doppler ultrasound is indicated .
Endoluminal sonography, is a sensitive and non-invasive method for preoperative assessment of uterine neoplasms, when carried out by expert practitioners, endoluminal sonography shows good accuracy in the local staging of cervical carcinoma.
It has been found to be cost-effective because in addition to its capability of accurate staging, it can replace multiple other tests, as computed tomography (CT), cystoscopy, and sigmoidoscopy.
It helps to decide operability, the type of operation and aids in the selection of patients who need a special referral to a gynaecologist oncologist.
Disadvantages of ultrasound include operator dependence , limited field of view, diminished utility in obese patients, poor tissue characterization and shadowing by bowel gas.
MR imaging is considered to be a problem-solving technique in the assessment of cancer cervix. MRI is non invasive and suited for examination of the pelvis. It is particularly advantageous due to the natural contrast of the pelvic fat, bowel gas and urine in the bladder. A major advantage of MRI is its direct multiplanar capability, which means that it has the ability to display anatomy in any plane.
In cervical cancer:
• MRI is an integral part in staging the primary tumour.
• MRI helps in identifying tumors without parametrial extension (stage Ib vs stage IIb), thereby stratifying patients for surgery and radiation therapy
• MRI can help in monitoring response to treatment, detecting complications and recurrence, and in planning radiotherapy.
• MRI has an established role in local staging and in assessing proximal extension of tumors in young women for feasibility of fertility-preserving surgery.
Dynamic post contrast MR imaging was shown to be reliable for preoperative staging of primary cervical carcinoma with overall high accuracy rate.
However, the perception that MRI is expensive limits its use in pelvic disease. Other disadvantage of MRI is its limited availability compared to ultrasound. There are numerous disadvantages related to the long scanning times required for MRI. The increased scanning times allow greater degradation of the images from movement and more cooperation from patients is required. It is uncomfortable to remain still for long periods, and sometimes claustrophobia can be a problem.
Both ultrasound and MRI are useful either interchangeably or in combination.
Conclusion:
Ultrasonography is the initial method to evaluate the pelvic organs in symptomatic patients. MRI should be used if the diagnosis will be used to determine the stageing and extention of cancer cervix if the ultrasound study is not definitive. Contrast- enhanced MRI is more accurate than US and non- enhanced MRI in the assessment of cancer cervix.