Transvaginal color Doppler ultrasound in the assessment of invasive cervical carcinoma

Objective: To assess the validity of transvaginal color Doppler flow in the prediction of malignancy in the uterine cervix. Study Design: Sixteen women with cervical pathology (14 with invasive carcinoma and 2 with cervical intraepithelial neoplasia III) were examined using transvaginal sonography as well as transvaginal color Doppler with measurements of the resistance index of tumor blood flow. Twenty-four women with histologically proven normal cervices served as a control group. Results: Resistence index (RI) was significantly lower in the study group 10,493; 0,475-0.511 (mean + 95% CI)] than in the control group [0.643; 0.627-0.659] (P < 0.0001) (t'). There was no statistically significant difference between the carcinoma group and the CIN III cases (P = 0.067) (t'). Only two cases with cervical carcinoma showed dense vascularity with color Doppler. A RI cutoff less than or equal to 0.573 showed a sensitivity of 81% with a specificity of 93%, a positive predictive value of 93%, and a negative predictive value of 81%. Conclusions: Color Doppler flow evaluation of RI in cervix vessels may aid in the early diagnosis and management of cervical carcinoma and in differentiating benign from malignant tumors. The validity of this technique as a screening program for diagnosis is limited.