Power Doppler angiographic appearance and blood flow velocity waveforms in invasive cervical carcinoma.
OBJECTIVE
The aim of this study was to investigate the effectiveness of transvaginal power Doppler angiography in predicting cervical malignancy by detecting intratumoral blood flow and to understand the relationship between squamous cell carcinoma (SCC) serum levels and intratumoral blood flow analysis of invasive cervical carcinoma before treatment.


METHODS
Thirty-eight patients with cervical carcinoma (35 with stages Ia to IVb invasive carcinoma, 3 with cervical carcinoma in situ) were enrolled for the evaluation of tumor flow using transvaginal ultrasound accompanied with power Doppler angiography before surgery. The pulsatility, resistance index, and vascular index of tumor flow were measured. Thirty patients with proven healthy cervices were used as the control group. Pretreatment SCC serum levels were obtained in 34 women with cervical carcinoma.


RESULTS
The pulsatility index and resistance index were significantly lower in the study group than in the control group (P < 0.0001). The vascular index was also significantly lower in the study group than in the control group (P < 0.0001). There were no significant differences among patients with SCC type and non-SCC type cervical carcinoma (P > 0.05) among the six parameters. There was no significant correlation between the pretreatment SCC serum levels with any of the six parameters obtained from the intratumoral blood flow analysis in the SCC group.


CONCLUSIONS
Transvaginal ultrasound with power Doppler angiography is a valuable diagnostic tool for differentiating benign tumors of the cervix from malignant ones. Intratumoral blood flow of the cervix supplied us with practical diagnostic information before surgery and may aid in early prediction and management of cervical carcinoma. The use of transvaginal ultrasound with power Doppler angiography in the grading of vascularity ratio within cervical masses provided more sonographic characteristics among the different subclassifications of cervical cancer and is more useful than color Doppler imaging in the visualization of sonographic morphology.
Wu
Y C
YC
Department of Obstetrics and Gynecology, Veteran General Hospital-Taipei, 201, Section 2, Shih-Pai Road, Taipei, Taiwan, Republic of China.
Yuan
C C
CC
Hung
J H
JH
Chao
K C
KC
Yen
M S
MS
Ng
H T
HT
D000230:Adenocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000276:immunology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D000951:Antigens, Neoplasm / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D001783:Blood Flow Velocity; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000000981:diagnostic imaging / Q000276:immunology; D002584:Cervix Uteri / Q000098:blood supply / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015843:Serpins; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000276:immunology
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen