Xie Meng, Zhang Xuyin, Yu Meng, Wang Wenping, Hua Keqin
Departments of Ultrasound, Fudan University, Shanghai, China.
Departments of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
J Ultrasound Med. 2018 May;37(5):1109-1114. doi: 10.1002/jum.14457. Epub 2017 Oct 16.
The purpose of this study was to investigate the stiffness of the cervix after the loop electrosurgical excision procedure (LEEP) by transvaginal elastography and its potential ability to predict future pregnancy.
A retrospective study included patients of reproductive age who underwent LEEP for cervical high-grade squamous intraepithelial lesions on the basis of colposcopic findings and who desired fertility. The characteristics on conventional transvaginal ultrasonography and elastography before and 6 months after LEEP were reviewed and analyzed. Each case had a 12-month follow-up, and the information on pregnancy and a cervical cytologic examination was recorded.
Fifty-three patients who completed the 12-month follow-up were included in the analysis. Thirty-two cases (group 1) were pregnant during the follow-up, and the other 21 (group 2) had pregnancy failure. The cervical lengths of group 1 and 2 as measured by traditional transvaginal ultrasonography were similar before and 6 months after LEEP. The resistive index of group 1 was significantly higher 6 months after LEEP than before LEEP (mean ± SD, 0.88 ± 0.36 versus 0.42 ± 0.22; P = .007). The mean elasticity score for the cervix was statistically significantly lower after LEEP (2.21 ± 0.53) than before (3.46 ± 0.78; P = .001) in group 1. However, in group 2, the mean elasticity scores were similar after LEEP (3.19 ± 0.58) and before (3.25 ± 0.66; P = .75).
Our results suggest that elastography was a useful technique for evaluating the stiffness of the cervix after LEEP. Elastography could provide a potential means to predict future pregnancy after LEEP.
本研究旨在通过经阴道弹性成像技术研究宫颈环形电切术（LEEP）后宫颈的硬度及其预测未来妊娠的潜在能力。
一项回顾性研究纳入了因阴道镜检查发现宫颈高级别鳞状上皮内病变且有生育意愿的育龄患者。回顾并分析了LEEP术前及术后6个月的传统经阴道超声和弹性成像特征。对每个病例进行12个月的随访，并记录妊娠和宫颈细胞学检查信息。
53例完成12个月随访的患者纳入分析。32例（第1组）在随访期间怀孕，另外21例（第2组）妊娠失败。传统经阴道超声测量的第1组和第2组宫颈长度在LEEP术前及术后6个月相似。第1组LEEP术后6个月的阻力指数显著高于术前（均值±标准差，0.88±0.36对0.42±0.22；P = 0.007）。第1组LEEP术后宫颈平均弹性评分在统计学上显著低于术前（2.21±0.53对3.46±0.78；P = 0.001）。然而，在第2组中，LEEP术后平均弹性评分与术前相似（3.19±0.58对3.25±0.66；P = 0.75）。
我们的结果表明，弹性成像是评估LEEP术后宫颈硬度的有用技术。弹性成像可为预测LEEP术后未来妊娠提供一种潜在方法。
