Chen Qian1#, Zhen Zhen2#, Yiling Kang1, Yu Gao2, Yong Huang3*
1Department of Ultrasound, Nantong Maternal and Child Health Care Hospital, Nantong, Jiangsu 226006, China - 2Department of Ultrasound, Liaocheng People's Hospital of Shandong Province, Liaocheng, Shandong 252000, China - 3Ultrasound of Department, Jiangjin District Central Hospital, Chongqing 402260, China
Objective: To study the value of transvaginal and transabdominal color Doppler ultrasound (color ultrasound) in the diagnosis of cervical malignancies.
Methods: 310 patients with suspected cervical malignant lesions admitted to our hospital from January 2018 to January 2020 were selected as observation subjects. All patients underwent transabdominal and transvaginal color Doppler ultrasonography and cervical needle aspiration biopsy, Thinprep cytologic test (TCT), and histopathological examination. The diagnostic efficacy indexes of transabdominal and transvaginal color Doppler ultrasonography and the combination of both were calculated based on the results of the cervical biopsy, TCT, and histopathological examination. The receiver operating characteristic curve (ROC) was plotted and the area under the ROC curve (AUC) was calculated to assess the diagnostic value. The diagnostic compliance of transabdominal, transvaginal, and both combined examinations for the staging of cervical malignancy was analyzed.
Results: The gold standard confirmed the diagnosis of cervical malignancy in a total of 267 cases. There was no statistical agreement between transabdominal ultrasound diagnosis and the gold standard (Kappa<0.4, P>0.05), the agreement between transvaginal ultrasound and the gold standard (0.4≤Kappa≤0.6, P<0.05), and high agreement between combined diagnosis and the gold standard (0.8<Kappa≤1.0, P<0.05). The combined diagnostic efficacy was the best, with a diagnostic compliance rate of 96.13%, followed by transvaginal ultrasound (80.39%) and the lowest transabdominal ultrasound (53.55%). Combined transabdominal and transvaginal ultrasound had a high diagnostic value in the diagnosis of cervical malignancy (AUC>0.9, P<0.05). The differences between transabdominal and transvaginal ultrasound clinical staging results and gold standard staging results were statistically significant (P<0.05), and the differences between combined ultrasound and gold standard were not statistically significant (P>0.05).
Conclusion: The diagnostic value of transvaginal color Doppler ultrasound in diagnosing cervical malignancy and determining clinical stage is higher than that of transabdominal ultrasound, but the combined application of the two can further improve the diagnostic value of color ultrasound.
Cervical Malignancy, Transabdominal Color Doppler Ultrasound, Transvaginal Color Doppler Ultrasound.