Diagnostic Value of Biplane Transrectal Color-Doppler Ultrasound in High-Grade Cervical Squamous Intraepithelial Lesions: A Retrospective Study.

OBJECTIVE: To investigate the diagnostic value of biplane transrectal ultrasound (TRUS) combined with color Doppler imaging in uterine cervical high-grade squamous intraepithelial lesions (HSILs). MATERIALS AND METHODS: A retrospective analysis was performed on 46 patients with pathologically confirmed HSILs admitted from September 2022 to December 2024. All patients underwent transvaginal and biplane transrectal cervical ultrasound examinations. The two-dimensional grayscale images, color Doppler flow imaging characteristics, and hemodynamic parameters including blood flow pixel ratio and arterial resistance index were compared between HSILs and non-involved areas. Receiver operating characteristic (ROC) curve analysis was used to calculate the sensitivity and specificity at different cutoff values. The Youden index was calculated, and the cutoff value corresponding to the maximum Youden index was defined as the optimal threshold. Statistical analyses were performed using SPSS version 26.0 (SPSS Inc. Chicago, IL, USA), with p < 0.05 considered statistically significant. RESULTS: Among the 46 patients reviewed, a total of 117 cervical intraepithelial neoplasia (CIN) lesions were detected, including 69 CIN2 lesions and 48 CIN3 lesions. Biplane TRUS combined with Color-Doppler imaging revealed significant differences: HSILs exhibited increased blood flow signals, thickened and tortuous blood vessels, with a predominant branch-like vascular pattern (63.25%), whereas the non-involved areas were mainly characterized by a line-like vascular pattern (88.89%). The median blood flow pixel ratio in HSILs (53.58%) was significantly higher than that in the non-involved areas (14.26%) (p < 0.001). The area under the receiver operating characteristic curve was 0.874 (95% confidence interval: 0.829-0.919) when the cutoff value 41.625% was determined, with a sensitivity of 68.38% and a specificity of 96.58%. No statistically significant differences were observed in peak systolic velocity and resistance index of the cervical arteries between the HSILs and non-involved areas (p > 0.05). CONCLUSION: Biplane TRUS combined with color Doppler imaging may serve as a useful adjunctive, non-invasive valuable tool in the evaluation and diagnosis of cervical HSILs in gynecological practice.