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385 abnormal computer tomograms of the organs in the lesser pelvis were analysed; the normal anatomy, indications for CT and its value are discussed. Particular attention is paid to the relevance of the computer tomographic information for treatment.
Five-year results of treatment in 661 patients with cervical cancer depending on the technic of dose fractionation in external irradiation of the lesser pelvis under static gamma therapy are reported. Two methods of fractionation were employed: small (daily irradiation, the single focal dose of 125--150 rad) and average dose fractionation (irradiation 3 times a week, focal dosage--280--330 rad). In similar initial data (age, stage of the disease, a form of tumor growth and its histological structure) both with the combined and associated radiotherapy the best five-year results were gained with average dose fractionation.
One hundred and twenty-three female patients were subjected to ultrasound and CT examinations on account of suspected tumours in the area of the lesser pelvis, or to evaluate the postoperative situation. Twenty-five patients were subjected in addition to the mentioned examinations also to angiography of the pelvic arteries. From comparison of the results of the radiodiagnostic examination and the surgical (histological) diagnosis ensues that in patients with a malignant tumour of the ovaries and uterus and with a benign tumour of the uterus the CT examination gives-more satisfactory results than the ultrasound examination. In patients with a benign tumour of the ovaries ultrasonic and CT examinations were approximately equally satisfactory.
Technological innovations which change diagnostic routines are continually being introduced in medical care, as exemplified by magnetic resonance imaging (MRI) with its advanced diagnostic capacity, now considered indispensible for the investigation of many disorders of the central nervous system. The article consists in an outline of applications of MRI in the investigation of the lower abdomen, a field characterised by substantial technical improvements in recent years, and a brief review of subject literature. Based on their experience of pelvic MRI, the authors advocate its more frequent use in investigating disorders of the lesser pelvis.
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An analysis of the author's findings showed a correlation between clinical manifestations of tumor, on the one hand, and its growth rate, size and, to a lesser degree, morphological pattern, on the other. Large size of tumor should not necessarily be interpreted as an indication of inoperability. A better 5-year survival following surgery in benign tumor group (82.1%) as compared with malignant tumors (24.5%) was confirmed.
Spatial resolution of MRI within the true pelvis can be increased by a factor of 12 using an endorectal coil. The value of this new method for demonstrating the prostate, the rectum, the cervix and vagina and of pathological processes of these organs was examined in 89 patients and the results compared with conventional body coil MRI. In 25 patients who underwent radical surgery the results of the preoperative studies were compared with the histological findings. Detailed recognition of anatomical structures was markedly improved by using the endorectal coil. Diagnosis of carcinoma of the prostate and extension of the tumour was accurately assessed in 33 patients. Preoperative staging was correct in 87%, compared with 73% when using a body coil. The difference was less marked in examinations for carcinomas of the rectum, the cervix and vagina. Nevertheless, staging was more accurate in a few cases with a better recognition of recurrences. MRI with endorectal coils will have an important role in diagnosis of carcinomas of the prostate in the future. Its use in the diagnosis of carcinomas of the rectum and cervix must be subject to further studies.