Possibilities of using Dopplerography in squamous intraepithelial neoplasia of the cervix

Improvements in screening programs have significantly increased the number of newly diagnosed cases of cervical cancer at the in  situ stage. However, the methods used are not always sufficiently sensitive and specific. Determination of blood flow indices in the uterine arteries and cervical arteries during transvaginal ultrasound examination (TVUS) with Dopplerography can be considered as an additional screening method.
Purpose of the study. To assess the relationship between the blood flow indices of the uterine and cervical arteries with different degrees of squamous cell intraepithelial neoplasia of the cervix TVUS with Dopplerography.
Patients and methods. The study included 60 patients. The 1st study group included 20 patients with high grade squamous intraepithelial lesion (HSIL) infected with HPV of high carcinogenic risk (mainly types 16 and 18). The 2nd group included 20 patients with low grade squamous intraepithelial lesion (LSIL) and HPV of low carcinogenic risk. The control group included 20 healthy female patients. All patients underwent a comprehensive transabdominal and TVUS was performed in real time on Ressona 7, Mindray (Germany) ultrasound machines. Resistance index (RI) of the uterine arteries and cervical vessels were measured by Doppler ultrasound and calculated automatically for each identified artery. Statistical analysis was performed using Microsoft Excel 365 and SPSS 20.0 software packages. Differences were considered statistically significant at p < 0.05.
Results. According to the results of the analysis of variance the RI of the cervical arteries in the 1st study group (0.37 (0.25–0.57)) was significantly lower (p < 0.001). In the 2nd study group (0.63 (0.59–0.67)), there was a tendency to decrease (p = 0.09) compared with the control group (0.70 (0.61–0.73)). The analysis of the parameters within the two study groups revealed a significant (p < 0.001) decrease in cervical artery pressure in group 1 (0.37 (0.25–0.57)) compared with group 2 (0.63 (0.59–0.67)). No correlation was noted in the correlation analysis of the RI of the cervical arteries and uterine arteries in Study Group I and II.
Conclusion. The use of TVUS with Dopplerography in combination with other screening methods can be used as an additional method to improve the results of early diagnosis and treatment of precancerous diseases of the cervix.

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