Three-Dimensional Microscopic Characteristics of the Human Uterine Cervix Evaluated by Microtomography

Objectives: To analyze the microscopic anatomy of the human uterine cervix in two-dimensional (2D) and three-dimensional (3D) images obtained by microtomography (microCT). Methods: Human uterine cervixes surgically removed for benign gynecologic conditions were immersed in formalin and iodine solution for more than 72 h and images were acquired by microtomography. Results: In total, 10 cervical specimens were evaluated. The images provided by microCT allowed the study of the vaginal squamous epithelium, demonstrated microscopic 3D images of the metaplastic process between the exo and endocervix, and demonstrated the effects of metaplastic transformation on the thickness of the endocervical epithelium. Also reconstructed in 3D the endocervical folds and the repercussions of the metaplastic process on the endocervix, the changes of the endocervical epithelium along the cervical lumen and the relationship between the endocervix epithelium from the internal os and endometrium. In addition, 2D images could demonstrate the difference in tissue orientation of the collagen on the cervical stroma in a large field of view. Conclusions: MicroCT could demonstrate the microscopic anatomy of the human uterine cervix in 2D and 3D images, including the different stages of metaplastic process of the endocervical epithelium and reconstructed the endocervical lumen in 3D, preserving its natural anatomy without any mechanical effect for its dilatation.