Ultrasound of the Uterosacral Ligament, Parametrium, and Paracervix: Disagreement in Terminology between Imaging Anatomy and Modern Gynecologic Surgery

Journal of Clinical Medicine

Marco Libera¹  BrunaA. Virgilio¹  Marco Noventa²  Arnaldo Scardapane³  Filomenamila Lorusso³  Marco Scioscia⁴ 

[1] Department of Obstetrics and Gynecology, Policlinico Hospital, 35031 Abano Terme, Italy;Department of Women and Children’s Health, Clinic of Gynecology and Obstetrics, University of Padua, 35121 Padua, Italy;Section of Diagnostic Imaging, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70100 Bari, Italy;Unit of Gynecological Surgery, Mater Dei Hospital, 70125 Bari, Italy;

关键词: endometriosis;    cervical cancer;    ultrasound;    anatomy;    ureter;    nerves;   

DOI  :  10.3390/jcm10030437

来源: DOAJ

【 摘 要 】

Ultrasound is an effective tool to detect and characterize lesions of the uterosacral ligament, parametrium, and paracervix. They may be the site of diseases such as endometriosis and the later stages of cervical cancer. Endometriosis and advanced stages of cervical cancer may infiltrate the parametrium and may also involve the ureter, resulting in a more complex surgery. New functional, surgical anatomy requires the complete diagnostic description of retroperitoneal spaces and tissues that contain vessels and nerves. Most endometriosis lesions and cervical cancer spread involve the cervical section of the uterosacral ligament, which is close to tissues, namely the parametrium and paracervix, which contain vessels and important nerves and nerve anastomoses of the inferior hypogastric plexus. Efferent fibers of the plexus travel to the rectum, uterus, rectovaginal ligament, deep vesicouterine ligament, and bladder. These efferent fibers are essential for bladder and rectal functionality so tailored nerve-sparing surgery became a standard approach for treating deep infiltrating endometriosis and cervical cancer. An accurate diagnosis by ultrasound has significant clinical impact and is important for appropriate treatment. In this article, we try to establish a common terminology between imaging diagnostic and modern surgical anatomy.

【 授权许可】

Unknown