US of the Nongravid Cervix with Multimodality Imaging Correlation: Normal Appearance, Pathologic Conditions, and Diagnostic Pitfalls

Joseph C Wildenberg, Benjamin L Yam, Jill E Langer, Lisa P Jones
Radiographics : a review publication of the Radiological Society of North America, Inc · 2016 · vol. 36(2) , pp. 596–617 · doi:10.1148/rg.2016150155 · PMID:26963464 · W2293589786
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Abstract

The adult uterine cervix may exhibit a wide variety of pathologic conditions that include benign entities (eg, cervicitis, hyperplasia, nabothian cysts, cervical polyps, leiomyomas, endometriosis, and congenital abnormalities) as well as malignant lesions, particularly cervical carcinoma. In addition, lesions that arise in the uterine body may secondarily involve the cervix, such as endometrial carcinoma and prolapsed intracavitary masses. Many of these conditions can be identified and characterized at ultrasonography (US), which is considered the first-line imaging examination for the female pelvis. However, examination of the cervix is often cursory during pelvic US, such that cervical disease may be overlooked or misdiagnosed. Transabdominal US of the cervix may not afford sufficient spatial resolution to depict cervical disease in many patients; therefore, endovaginal US is considered the optimal technique. Use of supplemental imaging techniques, particularly the application of transducer pressure on the cervix, may be helpful. This review describes the normal appearance of the cervix at US, the appearance of cervical lesions and conditions that mimic abnormalities at US, and optimal US techniques for evaluation of the cervix. This information will help radiologists detect and diagnose cervical abnormalities more confidently at pelvic US. Online supplemental material is available for this article.

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Condition tags

endometriosis

MeSH descriptors

Cervix Uteri Multimodal Imaging Ultrasonography Uterine Cervical Diseases 46, XX Disorders of Sex Development 46, XX Disorders of Sex Development Cervix Uteri Cervix Uteri Cervix Uteri Cervix Uteri Congenital Abnormalities Congenital Abnormalities Cysts Cysts Diagnosis, Differential Female Humans Hyperplasia Magnetic Resonance Imaging Mullerian Ducts

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