| Objective: Through the application of transvaginal real-time ultrasound elastography technical inspection in normal cervix and cervical lesions , sum up elastic image features of normal cervix and of benign and malignant lesions.And investigate the value of transvaginal ultrasound real time elasticity imaging in the differential diagnosis of cervical lesions and clinical application of cervical carcinoma infiltrating in the assessment of the scope .Methods : 20 cases of normal cervix, 20 cases of benign lesions and 40 cases of malignant lesions were examined by conventional ultrasound and transvaginal real-time elastography and compared with the pathology .All of them were evaluated by improved elastographic strain scores,which were classified into 5. We summed up elastic image features of normal cervix and of benign and malignant lesions.And investigated the value of transvaginal ultrasound real time elasticity imaging in the differential diagnosis of cervical lesions and clinical application of cervical carcinoma infiltrating in the assessment of the scopeResults:1.The elastic image features of normal cervix ,cervical benign lesions and cervical cancer1.1Normal cervical elastic image appeared as a uniform of green, red and a little less blue, cervical canal, serous layer of the uterine cervix and upper vagina wall displayed in red. The elasticity scores of normal cervix were 1. (20/20)1.2Elastic image displayed of benign space-occupying lesions of the cervix to mainly with some red and Green Center a little blue.Polyps on the elastic image were more red than normal cervix and myoma. There were 13 benign space-occupying lesions were 1 score ,( 13/20),6 benign space-occupying lesions were 2 score(6/20)and one of that was 3 score(1/20).When the score≤2 was set for cut-off criteria of benign space-occupying lesions,19 lesions were recorded benign lesions.The accuracy was 95%.The strain ratios of benign lesions was 0.75±0.32. The strain ratios of myomas was 1.09±0.10. The strain ratios of Polyps was 0.53±0.20.1.3Elastic image displayed of cervical cancer to mainly with some blue and accompanied the little green and very little red .There were 9 malignant lesions were 5 score ,( 9/40),23 malignant lesions were 4 score(23/40)6 malignant lesions were 3 score (6/40)and two of them were 2score(2/40).None of them were one score. When the score≥3 was set for cut-off criteria of malignant lesions,38 lesions were recorded malignant lesions.The accuracy was 95%.The strain ratios of 38 malignant lesions was 3.31±1.47.2. The comparison of elastic image features of normal cervix and of benign and malignant lesions2.1 Comparison between elastic semi-quantitative When the score≤2 was set for cut-off criteria of benign space-occupying lesions,19 lesions were recorded benign lesions.The accuracy was 95%. When the score≥3 was set for cut-off criteria of malignant lesions,38 lesions were recorded malignant lesions.The accuracy was 95%.2.2 Comparison between elastic quantitativeThere were significant difference between benign lesions and malignant lesions in elastic strain rate ratio. (p<0.01)3.The comparison of ultrasound elastography and conventional ultrasound in the assessment of the scope of cervical carcinoma.3.1 The relation of cervical cancer focus of infection and palace boring.There was significant difference between ultrasound elastography and conventional ultrasound in the assessment of the scope of cervical carcinoma. The results of elastic image and the pathology assumed the remarkable positive phase. (r=0.970)The results of conventional ultrasound and the pathology assumed the positive phase. (r=0.790)3.2 The relation of cervical cancer focus of infection and the vagina dome. There was significant difference between ultrasound elastography and conventional ultrasound in the assessment of the scope of cervical carcinoma. The results of elastic image and the pathology assumed the remarkable positive phase. (r=0.945)The results of conventional ultrasound and the pathology assumed the positive phase. (r=0.682)3.3The comparison of the size of cervical carcinoma.The size of cervical carcinoma in the elastic image was greater than that in the conventional ultrasound . There were significant difference. (p<0.05). There were no significant difference of the size of cervical carcinoma in the elastic image and in the pathology(p<0.01). The focus of infection size measured the value supersonic was good with the pathology result correlation. (r=0.992)The size of cervical carcinoma in the conventional ultrasound had the correlation with the pathology result. (r=0.890)Conclusion:1.The elastic image characteristic of the normal cervix, benign space-occupying lesions and the cervical cancerThe score of the normal cervix was 1. The score of benign space-occupying lesions was not more than 2. The strain ratios of benign lesions was 0.75±0.32. The strain ratios of myomas was 1.09±0.10. The strain ratios of Polyps was 0.53±0.20.The score of the cervical cancer was not less 3. The strain ratios of 38 malignant lesions was 3.31±1.47.2.It was valuable for transvaginal real-time ultrasound elastography in differentiating benign and malignant lesions.The score of benign space-occupying lesions was not more than 2. The score of the cervical cancer was not less 3. The strain ratios of benign lesions was 0.75±0.32. The strain ratios of thirty-eight malignant lesions was 3.31±1.47.3.Transvaginal real-time ultrasound elastography had advantage in cervical carcinoma infiltrating in the assessment of the scope ,especially in some suspicious cases in the conventional ultrasound. |
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