Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus N, Denmark.
Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers NØ, Denmark.
Arch Gynecol Obstet. 2024 Oct;310(4):2023-2033. doi: 10.1007/s00404-024-07693-x. Epub 2024 Aug 29.
Conventional vaginal strain ultrasound elastography, not based on shear-wave elastography imaging, can assess the biomechanical properties of the uterine cervix. This assessment may inform the risks of preterm birth and failed induction of labor. However, there is considerable variation in the approaches to strain elastography, including the placement of the region of interest (ROI). Therefore, our aim was to provide recommendations for cervical elastography.
We conducted a literature review on (1) elastography principles, and (2) the cervical anatomy. Subsequently, we performed elastography scanning using a Voluson E10 Expert scanner with the BT18 software of (3) polyacrylamide hydrogel simulators, and (4) pregnant women.
Increasing the distance between the ROI and probe led to a decrease in the obtained strain value; a 53% decrease was observed at 17.5 mm. Similarly, an increased angle between the ROI and probe-centerline resulted in a 59% decrease for 40° angle. Interposition of soft tissue (e.g., cervical canal) between the ROI and the probe induced an artifact with values from the posterior lip being 54% lower than those from the anterior lip, even after adjusting for probe-ROI distance. Equipment and the recording conductance significantly influenced the results.
Our findings inform recommendations for future studies on strain cervical elastography.
传统的阴道应变超声弹性成像，不基于剪切波弹性成像成像，可以评估子宫颈的生物力学特性。这种评估可以提示早产和引产失败的风险。然而，应变弹性成像的方法存在很大差异，包括感兴趣区域（ROI）的放置。因此，我们的目的是为宫颈弹性成像提供建议。
我们对（1）弹性成像原理和（2）宫颈解剖进行了文献回顾。随后，我们使用 Voluson E10 Expert 扫描仪和 BT18 软件对（3）聚丙烯酰胺水凝胶模拟器和（4）孕妇进行了弹性成像扫描。
ROI 与探头之间的距离增加导致获得的应变值减小；在 17.5 毫米处观察到 53%的减小。同样，ROI 与探头中心线之间的角度增加导致 40°角时应变减小 59%。ROI 和探头之间的软组织（例如宫颈管）的介入会产生伪影，使得后唇的数值比前唇低 54%，即使在调整探头-ROI 距离后也是如此。设备和记录电导显著影响结果。
我们的发现为未来的应变宫颈弹性成像研究提供了建议。
