Yu Cai-Cha, Jiao Yan, Wang Jia-Jia, Zhao Xiao-Si, Chen Lei
Department of Gynecology and Obstetrics Ultrasonography, Wenzhou Peoples' Hospital, Wenzhou, Zhejiang, China.
Department of Ultrasonography, Hangzhou Women's Hospital, Hangzhou, Zhejiang, China.
Technol Health Care. 2024;32(4):2345-2352. doi: 10.3233/THC-231106.
Endometrial receptivity is crucial for the establishment of a healthy pregnancy outcome. Previous research on endometrial receptivity primarily examined endometrial thickness, endometrial echo types, and endometrial blood supply.
To explore the differences in the elastic modulus of the endometrium in women with various pregnancy outcomes by real-time shear wave elastography (SWE) and to investigate its application value in evaluation of endometrial receptivity.
A total of 205 pregnant women who were admitted at Wenzhou People's Hospital between January 2021 and December 2022 were selected. Three-dimensional transvaginal sonography and real-time shear wave elastography were performed in the proliferative phase and receptive phase of the endometrium, and the average elastic modulus of the endometrium in the two phases was obtained and compared. According to whether the pregnancy was successful or not, the participants were divided into the pregnancy group (n= 72) and non-pregnancy group (n= 133), and the differences in intimal thickness, 3D blood flow parameters, and average elastic modulus of intima were compared between the two groups.
The average elastic modulus of the endometrium in the proliferative phase and receptive phase was (23.92 ± 2.31) kPa and (11.82 ± 2.24) kPa, respectively, and the difference was statistically significant P< 0.05. The average elastic modulus of the endometrium in the pregnancy group and non-pregnancy group was (9.97 ± 1.08) kPa and (12.82 ± 2.06) kPa, respectively, and the difference was statistically significant P< 0.05. The area under the curve of predicting pregnancy by the average elastic modulus of the endometrium in the receptive phase was 0.888 (0.841∼0.934), with corresponding P value < 0.05. The critical value was 11.15, with a corresponding sensitivity of 81.7% and specificity of 78.2%.
Real-time shear wave elastography can quantitatively evaluate endometrial elasticity, indirectly reflect the endometrial phase, and provide a new diagnostic concept for evaluating endometrial receptivity and predicting pregnancy outcome in infertile patients.
子宫内膜容受性对于实现健康的妊娠结局至关重要。以往关于子宫内膜容受性的研究主要检测子宫内膜厚度、子宫内膜回声类型及子宫内膜血供。
通过实时剪切波弹性成像（SWE）探讨不同妊娠结局女性子宫内膜弹性模量的差异，并研究其在评估子宫内膜容受性中的应用价值。
选取2021年1月至2022年12月在温州市人民医院就诊的205例孕妇。在子宫内膜增殖期和容受期进行三维经阴道超声检查及实时剪切波弹性成像，获取两个时期子宫内膜的平均弹性模量并进行比较。根据妊娠是否成功，将研究对象分为妊娠组（n = 72）和未妊娠组（n = 133），比较两组内膜厚度、三维血流参数及内膜平均弹性模量的差异。
子宫内膜增殖期和容受期的平均弹性模量分别为（23.92±2.31）kPa和（11.82±2.24）kPa，差异有统计学意义（P<0.05）。妊娠组和未妊娠组子宫内膜的平均弹性模量分别为（9.97±1.08）kPa和（12.82±2.06）kPa，差异有统计学意义（P<0.05）。容受期子宫内膜平均弹性模量预测妊娠的曲线下面积为0.888（0.841～0.934），相应P值<0.05。临界值为11.15，相应敏感度为81.7%，特异度为78.2%。
实时剪切波弹性成像可定量评估子宫内膜弹性，间接反映子宫内膜分期，为评估不孕患者子宫内膜容受性及预测妊娠结局提供了新的诊断思路。
