Is there parametrial invasion or there is no parametrial invasion ? 2a or 2b?

Is there parametrial invasion or there is no parametrial invasion ??

2a or 2b ?

I will go with involvement of parametrium

how can we know if there is invasion of the urinary bladder ?

by presence of tumor tissue on the inner side of bladder wall

the T2 hypointense peripheral cervical stroma is breached at the sites of arrows, T2 hyperintense tumor extends all through cervical stroma at these sites

involvement of mucosa of bladder or rectum (edema, as such, does not permit a case to be allotted to stage IV)

the most important is to define if it is 2b or 2a. Then if there is the uncommon adjacent organ invasion, it will be treated accordingly.

DWI: cx mass and bil pelvic lymph nodes show restriction of diffusion

parametrial invasion stage IIb … not fit for operation, for local irradiation brachytherapy.

Extension to anterior upper vagina, no bladder or rectal invasion, pelvic lymphadenopathy

Axial - T2 sequence is the strategic technique to depict parametrial invasion, postcontrast and DWI are complementary. It is actually axial oblique cuts; perpendicular to the long axis of cx on T2, marked by cursor on the sagittal, axial slide.

thank you professor

No parametrial invasion?