The value of transvaginal ultrasound multimodal imaging in the diagnosis of cervicallesions

Objective To compare the two-dimensional gray scale images, color flow imaging,the values of frequency spectrum and Young's modulus of normal cervix, cervical benign lesions and cervical cancer by transvaginal two-dimensional ultrasound, color Doppler flow spectrum and real-time shear wave elastography (SWE), and to evaluate their application in the diagnosis of cervical lesions. Methods A total of 40 patients with normal cervix were enrolled in a normal cervix group, and 30 patients who were pathologically diagnosed with cervical polyps, cervical myomas and cervical intraepithelial neoplasia were enrolled in a benign cervix group. Furthermore, 32 patients who were pathologically diagnosed with cervical cancer were enrolled in a cervical malignancy group. The three groups were examined by transvaginal ultrasound, and their two-dimensional images, color flow imaging, Doppler spectrum and Young's modulus were measured. Meanwhile, their values of Young's modulus and frequency spectrum of the cervix were compared. Results The normal cervix group presented uniform echo, without or with little spotted blood flow signals (RI > 0.55). In the benign cervix group, the echo was uniform or uneven, with little spotted blood flow signals (RI>0.55). In the cervical malignancy group, the echo was uneven, and the blood flow was rich, with low resistance in most of the blood flow signals (RI<0.55). Remarkable increases were found as to the mean Young's modulus in the region of interest (ROI) in the cervical malignancy group (123.28±23.98)kPa, compared with the benign cervix group (56.12±15.34)kPa and the normal cervix group (38.78±9.98)kPa (P<0.05).There was no significant difference as to the mean Young's modulus between the benign and normal cervix groups (P>0.05). Conclusions Transvaginal ultrasound combined with two-dimensional ultrasound, color Doppler flow spectrum and SWE multimodal examination can distinguish benign and malignant cervical lesions, which is effective to diagnose cervical cancer in clinical setting.