Classification of Vascular Hotspots and Micro-Vessel Flow Velocity Waveforms in Low-Grade Squamous Intraepithelial Lesions and HPV Condyloma of the Cervix

Yi-Cheng Wu; Ching-Hsuan Chen; Yi-Li Ko; Chiou-Chung Yuan; Peng-Hui Wang; Woei-Chyn Chu

doi:10.3390/diagnostics12102390

Classification of Vascular Hotspots and Micro-Vessel Flow Velocity Waveforms in Low-Grade Squamous Intraepithelial Lesions and HPV Condyloma of the Cervix

Diagnostics (Basel). 2022 Oct 1;12(10):2390. doi: 10.3390/diagnostics12102390.

Authors

Yi-Cheng Wu^{1

2

3}, Ching-Hsuan Chen⁴, Yi-Li Ko⁵, Chiou-Chung Yuan⁶, Peng-Hui Wang^{7

8

9

10}, Woei-Chyn Chu¹

Affiliations

¹ Department of Biomedical Engineering, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan.
² Department of Obstetrics and Gynecology, Ton Yen General Hospital, Hsinchu 302048, Taiwan.
³ Taiwan IVF Group Center for Reproductive Medicine & Infertility, Hsinchu 302053, Taiwan.
⁴ Department of Obstetrics and Gynecology, Fuyou Branch, Taipei City Hospital, Taipei 100027, Taiwan.
⁵ Nursing Department, Fu Jen Catholic University, New Taipei 242062, Taiwan.
⁶ Department of Obstetrics and Gynecology, Cheng Hsin General Hospital, Taipei 112201, Taiwan.
⁷ Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112201, Taiwan.
⁸ Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan.
⁹ Female Cancer Foundation, Taipei 104509, Taiwan.
¹⁰ Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan.

Abstract

To assess hotspot micro-vessel flow velocity waveforms in human papillomavirus (HPV) cervical infections using transvaginal power Doppler ultrasound (TV-PDU) and to explore the associations of these sonographic parameters with HPV condyloma and low-grade squamous intraepithelial lesions (LSIL) of the cervix. A total of 39 patients with cervical HPV infections with abnormal cytology and colposcopy results (26 cases of LSIL; 13 cases of HPV condyloma) were enrolled to assess the vascular classification of the cervix and micro-vessel flow velocity using TV-PDU before treatment; 40 individuals with a pathologically normal cervix were used as the control group; seven parameters were measured, including vascular grading classification (Class I, Class II, and Class III), lowest pulsatility index (PI), resistance index (RI), peak systolic velocity (PS), end-diastolic velocity (ED), time average maximum velocity (TAMV), and the vascular index (VI = PS/ED). According to vascular classification, most LSILs were class I (69.2%, 18/26), followed by class II (26.9%, 7/26) and class III (3.8%, 1/26). Most HPV condylomas were class I (92.3%, 12/13), and one was class II (7.7%, 1/13). PI, RI, VI (p < 0.0001), and the PSs (p < 0.05) were significantly lower in these cases than in the controls. The ED and TAMV were not significantly different between the patients and controls (p = 0.4985 and p = 0.1564). No sonographic parameter was significantly different between LSIL and HPV condyloma. The mean PI, RI, and VI were significantly lower in LSIL than in the controls. For HPV condyloma, a PI of 1.07 had an 84.6% sensitivity, 85.0% specificity, and an AUC of 88.8%; for LSIL, a PI of 1.08 had a 100% sensitivity, 85% specificity, and an AUC of 94.2%; for HPV infection (HPV condyloma + LSIL), a PI of 1.08 had a 94.9% sensitivity, 85% specificity, and an AUC of 92.4%. Hotspot vascular classification and micro-vessel flow velocity waveforms may provide a potential practical method for the auxiliary diagnosis of cervical HPV infection. The PI may represent a valuable index for distinguishing the micro-vessel flow velocity waveforms in LSIL and HPV condyloma. Since the case numbers were limited in the current study, further validation is needed.

Keywords: condyloma; human papillomavirus; low-grade squamous intraepithelial lesions; power Doppler ultrasound.

Abstract

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