Transvaginal three-dimensional color power Doppler ultrasound and cervical MVD measurement in the detection of cervical intraepithelial neoplasia

H. Liang, M. Fu, F.-M Liu, L. Song, L. Peng, J. Zhou

Cervical Disease Center, Xuzhou Maternity and Child Health Care Hospital, Xuzhou Medical College, Xuzhou, Jiangsu Province, China. fm8795@163.com

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• Gynecology

OBJECTIVE: To explore the potential correlation between three-dimensional color power Doppler ultrasound (3D-CPA) parameters and high-grade cervical lesions and early cervical cancer microvessel density (MVD) and investigate the role of transvaginal three-dimensional power Doppler ultrasonography in the detection of cervical intraepithelial neoplasia.

PATIENTS AND METHODS: Totally 90 subjects were randomly divided into three groups: the control group (n = 30, including patients with chronic cervicitis), the high-grade cervical intraepithelial neoplasia (CIN) group (n = 30, mainly CIN II-III), and the early cervical cancer group (stage Ia-IIa) (n = 30). All patients received preoperative 3D-CPA, and the cervical blood flow was graded. The cervical and intra-mass parameters including vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) were measured. The immunohistochemistry of the anti-CD34 monoclonal antibody was performed for the post-operative specimens obtained from each group. The MVD of the tumors was calculated. The difference of each parameter was compared among these three groups, and the correlations between the ultrasound vascular parameters and MVD were analyzed. The high-grade CIN group was followed up for 6 months after the loop electrosurgical excision procedure (LEEP) conization surgery with 3D-CPA.

RESULTS: Compared with the other two groups, the early cervical cancer group had significantly higher VI, FI, and VFI parameters (p < 0.01). Compared with the control group, all of the three parameters of the high-grade CIN group were significantly higher (p < 0.01). The MVD values increased from the control group to the high-grade CIN group, and in turn to the cervical cancer group, with significant differences between each pair (p < 0.05). MVD was positively correlated with the ultrasound parameters VI and VFI (r = 0.723, r = 0.692). There were significant differences among the three groups in terms of vascular morphology and type. However, the ultrasound parameters and vascular types were not significantly different between the postoperative CIN group and the control group.

CONCLUSIONS: 3D-CPA can be used to assess blood flow in the cervix. It is particularly useful for the early diagnosis of cervical cancer and CIN and for the postoperative follow-up of CIN.

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