Doppler ultrasound evaluation of blood flow patterns of the uterine arteries in pre- and postmenopausal women with cervical cancer and controls in Zaria

Abstract

Background: Cervical cancer remains an important health issue, especially in the developing countries that account for about 85% of the world burden of cervical cancer. Finding a role for Doppler ultrasound in the evaluation of these patients may reduce the cost and improve access to management. Aim: The study aimed at evaluating the Doppler flow parameters in pre- and postmenopausal patients with cervical cancer when compared to normal controls in a teaching hospital in Nigeria. Methodology: This is a prospective case–control observational study conducted over a period of 7 months (August 2016–February 2017) in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Eighty-one patients with cervical cancer and 81 age-matched controls had a transabdominal Doppler ultrasound examination of the main uterine arteries. The data were analyzed using SPSS version 20.0, Chicago, Illinois, USA. Statistical differences in the uterine artery indices between two groups were tested, andP < 0.05 was considered as statistically significant. Results: The mean resistive index (RI) and pulsatility index (PI) of the patients were 0.64 ± 0.12 and 1.26 ± 0.31, respectively, and of controls were 0.88 ± 0.08 and 2.60 ± 0.56, respectively. These showed significantly lower values in patients than the controls (P < 0.0001). The mean end-diastolic velocity (EDV) was significantly higher in patients than the controls (P < 0.0001). There was, however, no significant difference in the mean peak systolic velocity (PSV) in patients and controls (P = 0.97). Both premenopausal patients and controls had significantly lower RI and PI and significantly higher PSV and EDV compared to their postmenopausal counterpart. Conclusion: The findings showed that significant differences exist in the uterine artery Doppler flow parameters in patients with cervical cancer compared to the healthy controls and that these parameters are influenced by menopausal status of the women and the size of the cervical mass. Hence, Doppler helps in staging, prognosticating, and posttreatment evaluation of patients with cervical cancer.