The Diagnostic Value Of Three-dimensional Transvaginal Power Doppler Ultrasound And Elasticity In Cervical Cancer

Purpose:To discuss the the diagnostic value of three-dimensional transvaginal power doppler ultrasound and elasticity in cervical cancer, and compare the advantage of the two method.Materials and method:The study included a group of patients with cervical cancer (a total of40lesions), CIN group (a total of25lesions)and normal control group (20cases of healthy volunteers), patients are all examined one week before surgery with E9ultrasonic diagnostic apparatus of the GE company,which is equipped with the software of3D-PDUS and TVES. To start with, ask the patient to lie in the lithotomy position and put the transvaginal probe into the vaginal fornix slowly. First we viewed the cervix in transverse and longitudinal scan from all the aspects concerned in the two-dimensional ultrasonic mode, carefully observe the cervical morphology, size, internal echo and presence of lesions, cervical mucous membrane layer and the condition of the vagina, etc. Whenever a lump is spotted in the cervix, its internal and peripheral blood flow dynamics characteristics and distribution should be examined. Then switch to the elasticity imaging mode and examine the cervix of the patients and volunteers.We chose the Thomas5-score method as the standard to analysis the picture of normal cervix and cervical tumor. Last, we switch to the three-dimensional power doppler mode,and get three-dimensional histogram automatically with the help of VOCAL system computer algorithm. It tells the blood flow parameters of the tumor in the patient, while in the healthy volunteer, it tells the the blood flow parameters of whole cervix. The three blood flow parameters are VI (vascularization index),FI (flow index), VFI (vascularization-flow index,).We discuss the difference of elastic imaging score between the cervical cancer patients, CIN group and normal control group in the elasticity mode. In addition, the three-dimensional power doppler blood flow parameters Ⅵ、FI、 VFI are all compared among the patients from these group. When there is a statistically significant difference,we use the ROC curve to get the optimal cut-off point. In the end, we discuss the Accuracy, sensitivity, specific degree of the two-dimensional ultrasound,the3D-PDUS and TVES, and compare their diagnostic value in cervical cancer.Results:(1)The the blood flow parameters of3D-DPUS Ⅵ、FI、VFI are statistically higher in the cervical cancer group than in the normal and CIN one (P<0.05), while the Ⅵ、FI、VFI of the CIN group isn’t statistically different from the normal group (P>0.05).(2)The elastic score of the cervical cancer group are statistically higher than the normal group and the CIN group (P<0.05). Moreover, the elastic score of the CIN group is statistically higher than the normal one.(3)The accuracy of the3method from the high to low order are:TVES,3D-PDUS,TVS. There is statistically significant difference between TVES and TVS,3D-DPUS and TVS. But there is no statistically difference between the TVES and3D-PDUS.The sensitivity of the3method from the high to low order are: TVES,3D-PDUS,TVS. There is statistically significant difference between TVES and TVS,3D-DPUS and TVS. But there is no statistically difference between the TVES and3D-PDUS.The specificity of the3method from the high to low order are:TVES,3D-PDUS,TVS.There is statistically significant difference between TVES and TVS,3D-DPUS and TVS. But there is no statistically difference between the TVES and3D-PDUS.Conclusion:1、We can Infer benign and malignant cervical lesions from the tissue hardness, the information of which is provided by the TVES.It has a good application value in The diagnosis of cervical cancer.2、The3D-PDUS can provide information in diagnosing the cervical cancer by telling the blood flow within the cervical lump. In this way, we get to know the Local blood flow characteristics and the status of the angiogenesis within the tumor3、The TVES and3D-DPUS can Improve the detection rate of cervical cancer to some extent, which are good supplement ot TVS.4、3D-PDUS and TVES have the same accuracy, sensitivity and specificity in diagnosing cervical cancer...