Objective ：To investigate the correlation of elastic ultrasound imaging with different depth of invasion and pathological types of cervical cancer. Methods :A total of 83 patients with cervical cancer treated in our hospital from January 2018 to July 2021 were selected as the research objects and set as the cervical cancer group. Another 60 patients with cervical benign space-occupying lesions treated in our hospital during the same period were selected as the cervical benign lesion group.All patients underwent two-dimensional ultrasound and elastic ultrasound examination. The elastography score

elastic strain rate ratio and the optimal cut-off value of the two groups were compared. The diagnostic value of vaginal and paracyclic infiltration in the cervical cancer group was compared. Results : In the cervical cancer group

47 cases were ≤ 3cm in size

and 36 cases were ＞3cm. Lymph node metastasis was found in 11 cases. Infiltration depth ≤1/2 in 50 cases; infiltration depth > 1/2 in 33 cases. Among 49 cases of squamous cell carcinoma

21 cases were highly differentiated

13 cases were moderately differentiated and 15 cases were poorly differentiated. There were 19 cases of adenocarcinoma

among which 8 cases were highly differentiated

7 cases were moderately differentiated

and 4 cases were poorly differentiated. Adenosquamous carcinoma in 15 cases.The AUC was 0.85. The diagnostic efficiency was the best when the Youden index was the maximum. When the diagnostic criteria for malignant lesions was set to 4

the accuracy was 76.8%

the specificity was 83.2%

and the sensitivity was 75.8%.There was significant difference in the ratio of elastic strain rate between the benign lesion group and the cervical cancer group (t=6.157

P < 0.05). The AUC of strain rate ratio method in the diagnosis of cervical cancer was 0.86

the optimal cut-off value was 3.15

the specificity was 81.9%

and the sensitivity was 72.9%. The accuracy of vaginal infiltration was 82.1%

the specificity 83.4%

the sensitivity 71.9%

the misdiagnosis rate 14.5%

the missed diagnosis rate 31.2%

the Youden index 0.56; The accuracy

specificity

sensitivity

misdiagnosis rate

missed diagnosis rate and Youden index were 90.3%

91.4%

82.1%

9.4%

19.1% and 0.75

respectively.According to the size of the lesion

the cervical cancer group was divided into ≤3cm subgroup (n=47) and > 3cm subgroup (n=36)

and the difference was statistically significant (t=3.309

P<0.05). According to the depth of invasion

the cervical cancer group was divided into ≤1/2 subgroup (n=50) and > 1/2 subgroup (n=33)

and the difference was statistically significant (t=3.516

P<0.05).Unrepresentative adenosquamous carcinoma was excluded according to different pathological results. The cervical cancer group was divided into 19 adenocarcinoma subgroup and 49 squamous cell carcinoma subgroup

and the difference was statistically significant (t=2.819

P<0.05). There was no significant difference in strain rate ratio between different differentiation degrees of adenocarcinoma (F=0.923

P>0.05).There was significant difference in strain rate ratio between different differentiation degrees of squamous cell carcinoma (F=3.394

P<0.05). Pairwise comparison showed that there was significant difference between high differentiation and low differentiation (t=3.872

P<0.05)

while there was no significant difference between other groups (P>0.05). According to the difference of lymph node metastasis

the cervical cancer group was divided into 11 cases with lymph node metastasis subgroup and 72 cases without lymph node metastasis subgroup

and there was no statistical difference (t=1.138

P>0.05)..Conclusion :Elastic ultrasound imaging has high accuracy and specificity in the periuterine invasion of cervical cancer

but has limitations in the vaginal invasion. The size

depth of invasion

degree of differentiation and pathological type of cervical cancer were correlated with the ratio of elastic strain rate of cervical cancer

but not with lymph node metastasis.