[Endosonographic diagnosis in uterine tumors]

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)