Carlson L C, Feltovich H, Palmeri M L, Dahl J J, Munoz del Rio A, Hall T J
Medical Physics Department, University of Wisconsin, Madison, WI, USA.
Ultrasound Obstet Gynecol. 2014 Apr;43(4):452-8. doi: 10.1002/uog.12555. Epub 2014 Mar 12.
To explore spatial variability within the cervix and the sensitivity of shear wave speed (SWS) to assess softness/stiffness differences in ripened (softened) vs unripened tissue.
We obtained SWS estimates from hysterectomy specimens (n = 22), a subset of which were ripened (n = 13). Multiple measurements were made longitudinally along the cervical canal on both the anterior and posterior sides of the cervix. Statistical tests of differences in the proximal vs distal, anterior vs posterior and ripened vs unripened cervix were performed with individual two-sample t-tests and a linear mixed model.
Estimates of SWS increase monotonically from distal to proximal longitudinally along the cervix, they vary in the anterior compared to the posterior cervix and they are significantly different in ripened vs unripened cervical tissue. Specifically, the mid position SWS estimates for the unripened group were 3.45 ± 0.95 m/s (anterior; mean ± SD) and 3.56 ± 0.92 m/s (posterior), and 2.11 ± 0.45 m/s (anterior) and 2.68 ± 0.57 m/s (posterior) for the ripened group (P < 0.001).
We propose that SWS estimation may be a valuable research and, ultimately, diagnostic tool for objective quantification of cervical stiffness/softness.
探讨子宫颈内的空间变异性以及剪切波速度（SWS）评估成熟（软化）与未成熟组织的柔软度/硬度差异的敏感性。
我们从子宫切除标本（n = 22）中获得SWS估计值，其中一部分标本是成熟的（n = 13）。沿着子宫颈管在子宫颈的前后两侧纵向进行多次测量。使用个体双样本t检验和线性混合模型对子宫颈近端与远端、前部与后部以及成熟与未成熟子宫颈之间的差异进行统计检验。
SWS估计值沿子宫颈纵向从远端到近端单调增加，子宫颈前部与后部的SWS估计值有所不同，并且成熟与未成熟子宫颈组织的SWS估计值存在显著差异。具体而言，未成熟组中位位置的SWS估计值在前部为3.45±0.95米/秒（均值±标准差），后部为3.56±0.92米/秒；成熟组在前部为2.11±0.45米/秒，后部为2.68±0.57米/秒（P < 0.001）。
我们认为SWS估计可能是一种有价值的研究工具，并最终可能成为客观量化子宫颈硬度/柔软度的诊断工具。
