Complex ultrasonography in diagnostics of background diseases of the cervix
Abdullaiev R.Ya.1, Golovko T.S.2, Sibihankulov A.Kh. 1, Shcherbina O.V. 3, Korol P.O. 3
- 1Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
- 2National Cancer Institute, Kyiv, Ukraine
- 3Radiation Oncology and Radiation Safety, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
Summary. Among all benign processes of the cervix, more than 90% are non-neoplastic diseases that occur among women of reproductive age. Timely diagnosis and treatment of background diseases are an important for prevention of cervical cancer. Objective. To evaluate the possibilities of transvaginal ultrasonography in the diagnosis of background diseases of the cervix. Material and methods. A retrospective analysis of the results of a complex clinical-instrumental study was conducted in 83 women of reproductive age, in whom background pathological processes of the cervix were detected during histological analysis of scraping materials — cervical endometriosis in 39, endocervical hyperplasia in 31, CIN I in 13. Results. Deep slit-like hypoechoic inclusions were registered only in patients with CIN I — in 84.6% of cases. In the diagnosis of CIN I, the sensitivity of transvaginal ultrasound was 81.8%, the specificity was 50.0%, and the accuracy was 76.9%. Heterogeneous structure of the cervical stroma was most often observed in the group of patients with endometriosis CM (87.2%), then in patients with CIN I (46.2%), respectively (p<0.01). Subectocervical cysts with finely dispersed suspension with high probability (p<0.001) were more common in patients with cervical endometriosis (69.2%) than in other groups. The average value of cervical M-echo in patients with glandular hyperplasia was 8.4 mm, with adenomatous hyperplasia — 11.7 mm (p<0.001), in the comparison group — 5.7 mm, respectively. Endocervical cysts of rounded shape of small size (<2.0 mm) were significantly more often registered (p<0.05) in adenomatous hyperplasia (59.6%). Moderate endocervical (75.%) and subendocervical vascularization (87.5%) was significantly more frequent (p<0.05 and p<0.01) in patients with adenomatous hyperplasia. Conclusions. The glandular-fibrous form of hyperplasia of the endocervix is characterized by a cervical M-echo in the range of 8.1–10.0 mm and weak vascularization; for adenomatous hyperplasia, cervical M-echo within 10–13 mm, heterogeneous structure of the endocervix, moderate vascularization; for cervical endometriosis — a heterogeneous structure of the stroma of the cervix due to cystic cavities with dispersed suspension, lack of demarcation of the endocervix and stroma; for CIN I — deep slit-like hypoechoic inclusions on the mucous membrane of the external pharynx and the transition zone of the cervix.
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