Egorov Vladimir, Rosen Todd, van Raalte Heather, Kurtenoks Viktors
Advanced Tactile Imaging, Trenton, NJ, USA.
Department of Obstetrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Open J Obstet Gynecol. 2020 Jan;10(1):85-99. doi: 10.4236/ojog.2020.101008. Epub 2020 Jan 8.
Premature cervical softening and shortening may be considered an early mechanical failure that predisposes to preterm birth. Preliminary clinical studies demonstrate that cervical elastography may be able to quantify this phenomenon and predict spontaneous preterm delivery.
To explore a new approach for cervix elasticity and length measurements with tactile-ultrasound probe.
Cervix probe has tactile array and ultrasound transducer designed to apply controllable load to cervix and acquire stress-strain data for calculation of cervical elasticity (Young's modulus) and cervical length for four cervix sectors. Average values, standard deviations, intraclass correlation coefficients and the 95% limits of agreement (Bland-Altman plots) were estimated.
Ten non-pregnant and ten pregnant women were examined with the probe. The study with non-pregnant women demonstrated a reliable acquisition of the tactile signals. The ultrasound signals had a prolonged appearance; identification of the internal os of the cervix in these signals was not reliable. The study with pregnant women with the gestational age of 25.4 ± 2.3 weeks demonstrated reliable data acquisition with real-time visualization of the ultrasound signals. Average values for cervical elasticity and standard deviations of 19.7 ± 15.4 kPa and length of 30.7 ± 6.6 mm were calculated based on two measurements per 4 sectors. Measurement repeatability calculated as intraclass correlation coefficients between two measurements at the same cervix sector on pregnant women was found to be 0.97 for cervical elasticity and 0.93 for the cervical length. The 95% limits of agreement of 1) cervical elasticity were from -22.4% to +14.9%, and 2) cervical length from -13.3% to +16.5%.
This study demonstrated clinically acceptable measurement performance and reproducibility. The availability of stress-strain data allowed the computation of cervical elasticity and length. This approach has the potential to provide cervical markers to predict spontaneous preterm delivery.
宫颈过早软化和缩短可能被视为早产的早期机械性故障。初步临床研究表明，宫颈弹性成像可能能够量化这一现象并预测自发性早产。
探索一种使用触觉超声探头测量宫颈弹性和长度的新方法。
宫颈探头具有触觉阵列和超声换能器，旨在对宫颈施加可控负荷并获取应力应变数据，以计算四个宫颈区域的宫颈弹性（杨氏模量）和宫颈长度。估计了平均值、标准差、组内相关系数和95%一致性界限（Bland-Altman图）。
使用该探头对10名非孕妇和10名孕妇进行了检查。对非孕妇的研究表明，触觉信号采集可靠。超声信号出现时间延长；在这些信号中识别宫颈内口不可靠。对孕周为25.4±2.3周的孕妇的研究表明，超声信号实时可视化，数据采集可靠。基于每4个区域的两次测量，计算出宫颈弹性平均值为19.7±15.4kPa，长度为30.7±6.6mm。计算孕妇同一宫颈区域两次测量之间的组内相关系数得出，宫颈弹性测量重复性为0.97，宫颈长度为0.93。1）宫颈弹性的95%一致性界限为-22.4%至+14.9%，2）宫颈长度的95%一致性界限为-13.3%至+16.5%。
本研究证明了该测量方法在临床上具有可接受的性能和可重复性。应力应变数据的可用性使得能够计算宫颈弹性和长度。这种方法有可能提供宫颈标志物以预测自发性早产。
