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妊娠子宫颈剪切波弹性超声评估。

Shear-wave sonoelastographic assessment of cervix in pregnancy.

机构信息

Department of Obstetrics and Gynecology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.

Department of Obstetrics and gynecology, The Chinese University of Hong Kong, Hong Kong SAR.

出版信息

Acta Obstet Gynecol Scand. 2020 Nov;99(11):1458-1468. doi: 10.1111/aogs.13874. Epub 2020 May 15.

Abstract

INTRODUCTION

The aim of this study was to investigate the differences in shear-wave sonoelastography (SWS) scores between the different parts of cervix, explore the association between the cervical SWS scores with cervical length and evaluate repeatability of the measurement of cervical SWS scores.

MATERIAL AND METHODS

This was a prospective study performed in women with singleton pregnancy at 11-13 (n = 676), 16-20 (n = 364), 21-24 (n = 338) and 28-32 weeks (n = 304). The SWS scores were obtained at the inner, middle and external parts of the cervix, using a transvaginal ultrasound approach.

RESULTS

The SWS scores of the inner cervix were significantly higher than the measurements acquired at the middle and external parts (all P < .001). At 21-24 and 28-32 weeks, most regions of interest demonstrated a very weak positive correlation with cervical length (r = .125 to r = .299). In comparison with nulliparous women, parous women without prior preterm birth had higher SWS scores of the inner and middle parts of the cervix at 16-20 and 21-24 weeks. All regions of interest showed good intra- and inter-observer agreement.

CONCLUSIONS

The assessment of the cervical SWS scores is highly reproducible. The stiffness of the cervix demonstrates a gradient that decreases from the inner part to the external part and a very weak positive correlation with cervical length.

摘要

简介

本研究旨在探讨宫颈不同部位剪切波弹性成像(SWS)评分的差异,探讨宫颈 SWS 评分与宫颈长度的关系,并评估宫颈 SWS 评分测量的重复性。

材料和方法

这是一项在 11-13 周(n = 676)、16-20 周(n = 364)、21-24 周(n = 338)和 28-32 周(n = 304)单胎妊娠女性中进行的前瞻性研究。使用经阴道超声方法在宫颈内、中、外三部分获取 SWS 评分。

结果

宫颈内 SWS 评分明显高于中、外部分(均 P <.001)。在 21-24 周和 28-32 周,大多数感兴趣区域与宫颈长度呈非常弱的正相关(r =.125 至 r =.299)。与初产妇相比,无早产史的经产妇在 16-20 周和 21-24 周时宫颈内、中 SWS 评分较高。所有感兴趣区域的观察者内和观察者间一致性均较好。

结论

宫颈 SWS 评分的评估具有高度可重复性。宫颈的硬度呈梯度分布,从内部分到外部分逐渐降低,与宫颈长度呈非常弱的正相关。

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