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Alfuraih AM. The Emerging Role of Sonoelastography in Pregnancy: Applications in Assessing Maternal and Fetal Health. Diagnostics (Basel) 2024; 15:47. [PMID: 39795575 PMCID: PMC11720552 DOI: 10.3390/diagnostics15010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Revised: 12/25/2024] [Accepted: 12/25/2024] [Indexed: 01/13/2025] Open
Abstract
Sonoelastography, a novel ultrasound-based technique, is emerging as a valuable tool in prenatal diagnostics by quantifying tissue elasticity and stiffness in vivo. This narrative review explores the application of sonoelastography in assessing maternal and fetal health, with a focus on cervical, placental, pelvic floor, and fetal tissue evaluations. In the cervix, sonoelastography aids in predicting preterm birth and assessing labor induction success. For the placenta, it provides insights into conditions like preeclampsia and intrauterine growth restriction through elasticity measurements. Assessing fetal tissues, including the lungs, liver, and brain, sonoelastography offers a non-invasive method for evaluating organ maturity and detecting developmental anomalies. Additionally, pelvic floor assessments enable better management of childbirth-related injuries and postpartum recovery. While current studies support its safety when used within established limits, further research is necessary to confirm long-term effects. Future advancements include refining protocols, integrating machine learning, and combining sonoelastography with other diagnostic methods to enhance its predictive power. Sonoelastography holds promise as an impactful adjunct to conventional ultrasound, providing quantitative insights that can improve maternal and fetal outcomes in prenatal care.
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Affiliation(s)
- Abdulrahman M Alfuraih
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia
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2
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Jiang H, Bo Z. Application value of ultrasound elastography for screening of early pregnancy cervical insufficiency: a retrospective case-control study. J Matern Fetal Neonatal Med 2024; 37:2299111. [PMID: 38199820 DOI: 10.1080/14767058.2023.2299111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE This study aimed to investigate changes in the cervical strain rate (SR), cervical length (CL), and uterine artery blood flow parameters during early pregnancy in women with cervical insufficiency and evaluate the clinical efficacy of these markers for screening of cervical insufficiency in early pregnancy. METHODS This retrospective study in 60 pregnant women with cervical insufficiency and 100 normal pregnant women was conducted between September 2021 and January 2023 and measured ultrasound parameters of the cervix during early pregnancy. The cervical SR, CL, and uterine artery resistance index (RI) were measured in both groups at 11-14 weeks of gestation. Strain elastography represented by the SR was used to assess the hardness of the internal and external cervical openings. RESULTS During early pregnancy, the SR at the internal and external cervical openings were significantly higher in the cervical insufficiency group than those in the normal pregnancy group (SR I: 0.19 ± 0.018% vs. 0.16 ± 0.014%; SR E: 0.26 ± 0.028% vs. 0.24 ± 0.025%; p < .001). The CL was significantly shorter in the cervical insufficiency group than that measured in the normal pregnancy group (34.3 ± 2.9 mm vs. 35.2 ± 1.99 mm; p = .036), while cervical blood perfusion was also poorer in the cervical insufficiency group than that in the normal pregnancy group (uterine artery RI: 0.76 ± 0.07 vs. 0.74 ± 0.05; p = .048). Receiver operating characteristic (ROC) curve analysis showed that the optimal critical values for diagnosing cervical insufficiency were 0.17% for SR I, 0.25% for SR E, 33.8 mm for CL, and 0.78 for uterine artery RI. Of these parameters, the ROC curve for SR I had the largest area under the curve [AUC = 0.89 (p < .001)], with the highest sensitivity (78%) and specificity (82%). Multivariate logistic regression analysis demonstrated that the SR at the internal cervical opening (OR 17.47, 95% confidence interval (CI) 5.08-60.08; p < .001) and CL (OR 5.05, 95% CI 1.66-15.32; p = .004) still showed significant differences between the two groups. CONCLUSION Cervical elastography is an effective tool for screening early pregnancy cervical insufficiency. The SR at the internal cervical opening is a valuable indicator for screening cervical insufficiency and has superior clinical efficacy for screening for this condition compared to that of CL and the uterine artery blood flow index.
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Affiliation(s)
- Hua Jiang
- Department of Ultrasound in Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhang Bo
- Department of Ultrasound in Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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García A, Diez P, Rus G, Callejas A, Torres J. Reliability and robustness of a novel preclinical torsional wave-based device for stiffness evaluation. Sci Rep 2024; 14:16461. [PMID: 39013962 PMCID: PMC11252416 DOI: 10.1038/s41598-024-66661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024] Open
Abstract
In this work, we present a novel preclinical device utilizing Torsional Wave Elastography (TWE). It comprises a rotational actuator element and a piezoceramic receiver ring circumferentially aligned. Both allow the transmission of shear waves that interact with the tissue before being received. Our main objective is to demonstrate and characterize the reliability, robustness, and accuracy of the device for characterizing the stiffness of elastic materials and soft tissues. Experimental tests are performed using two sets of tissue mimicking phantoms. The first set consists of calibrated CIRS gels with known stiffness value, while the second test uses non-calibrated manufactured phantoms. Our experimental observations show that the proposed device consistently and repeatably quantifies the stiffness of elastic materials with high accuracy. Furthermore, comparison with established techniques demonstrates a very high correlation (> 95%), supporting the potential medical application of this technology. The results obtained pave the way for a cross-sectional study aiming to investigate the correlation between gestational age and cervical elastic properties during pregnancy.
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Affiliation(s)
| | | | - Guillermo Rus
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, 18071, Spain
- TEC-12 Group, Instituto de Investigación Biosanitaria, ibs., Granada, 18001, Spain
| | - Antonio Callejas
- Ultrasonics Lab (TEP-959), Department of Structural Mechanics, University of Granada, Granada, 18071, Spain.
- TEC-12 Group, Instituto de Investigación Biosanitaria, ibs., Granada, 18001, Spain.
| | - Jorge Torres
- LabTAU, INSERM, Centre Léon Bérard, Université Claude Bernard Lyon 1, Lyon, F-69003, France
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Louwagie EM, Russell SR, Hairston JC, Nottman C, Nhan-Chang CL, Fuchs K, Gyamfi-Bannerman C, Booker W, Andrikopoulou M, Friedman A, Zork N, Wapner R, Vink J, Mourad M, Feltovich HM, House MD, Myers KM. Uterus and cervix anatomical changes and cervix stiffness evolution throughout pregnancy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.01.592023. [PMID: 38746471 PMCID: PMC11092586 DOI: 10.1101/2024.05.01.592023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The coordinated biomechanical performance, such as uterine stretch and cervical barrier function, within maternal reproductive tissues facilitates healthy human pregnancy and birth. Quantifying normal biomechanical function and detecting potentially detrimental biomechanical dysfunction (e.g., cervical insufficiency, uterine overdistention, premature rupture of membranes) is difficult, largely due to minimal data on the shape and size of maternal anatomy and material properties of tissue across gestation. This study quantitates key structural features of human pregnancy to fill this knowledge gap and facilitate three-dimensional modeling for biomechanical pregnancy simulations to deeply explore pregnancy and childbirth. These measurements include the longitudinal assessment of uterine and cervical dimensions, fetal weight, and cervical stiffness in 47 low-risk pregnancies at four time points during gestation (late first, middle second, late second, and middle third trimesters). The uterine and cervical size were measured via 2-dimensional ultrasound, and cervical stiffness was measured via cervical aspiration. Trends in uterine and cervical measurements were assessed as time-course slopes across pregnancy and between gestational time points, accounting for specific participants. Patient-specific computational solid models of the uterus and cervix, generated from the ultrasonic measurements, were used to estimate deformed uterocervical volume. Results show that for this low-risk cohort, the uterus grows fastest in the inferior-superior direction from the late first to middle second trimester and fastest in the anterior-posterior and left-right direction between the middle and late second trimester. Contemporaneously, the cervix softens and shortens. It softens fastest from the late first to the middle second trimester and shortens fastest between the late second and middle third trimester. Alongside the fetal weight estimated from ultrasonic measurements, this work presents holistic maternal and fetal patient-specific biomechanical measurements across gestation.
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Wharton LK, Anumba DOC. Techniques for detecting cervical remodeling as a predictor for spontaneous preterm birth: current evidence and future research avenues in patients with multiple pregnancies. J Matern Fetal Neonatal Med 2023; 36:2262081. [PMID: 37778754 DOI: 10.1080/14767058.2023.2262081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Spontaneous preterm birth occurs more frequently in multiple pregnancies. This syndrome has multiple triggers that result in a unified downstream pathway of cervical remodeling, uterine activity, and progressive cervical dilatation. Whilst the triggers for labor in multiple pregnancy may be different from singletons, the downstream changes will be the same. Identifying patients at risk of preterm birth is a priority as interventions to delay delivery and optimize the fetus can be initiated. Methods for screening for risk of preterm birth which focus on the detection of cervical remodeling may therefore have potential in this population. METHODS This review explores the evidence for the predictive utility for preterm birth of several published techniques that assess the physical, biomechanical, and optical properties of the cervix, with a focus on those which have been studied in multiple pregnancies and highlighting targets for future research in this population. RESULTS Fifteen techniques are discussed which assess the physical, biomechanical, and optical properties of the cervix in pregnancy. Of these, only three techniques that evaluated the predictive accuracy of a technique in patients with multiple pregnancies were identified: uterocervical angle, cervical consistency index, and cervical elastography. Of these, measurement of the uterocervical angle has the strongest evidence. Several techniques have shown predictive potential in singleton pregnancies, but have not yet been studied in multiple pregnancies, which would be a logical expansion of research. CONCLUSION Research on techniques with predictive utility for PTB in patients with multiple pregnancies is limited but should be a research priority. Overall, the theory supports the investigation of cervical remodeling as a predictor of PTB, and there are numerous techniques in development that may have potential in this field.
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Affiliation(s)
- L K Wharton
- Academic Unit of Reproductive and Developmental Medicine, Faculty of Medicine Dentistry and Health, The University of Sheffield, Sheffield, UK
| | - D O C Anumba
- Academic Unit of Reproductive and Developmental Medicine, Faculty of Medicine Dentistry and Health, The University of Sheffield, Sheffield, UK
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Yoshida K. Bioengineering and the cervix: The past, current, and future for addressing preterm birth. Curr Res Physiol 2023; 6:100107. [PMID: 38107784 PMCID: PMC10724223 DOI: 10.1016/j.crphys.2023.100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/23/2023] [Accepted: 09/20/2023] [Indexed: 12/19/2023] Open
Abstract
The uterine cervix plays two important but opposing roles during pregnancy - as a mechanical barrier that maintains the fetus for nine months and as a compliant structure that dilates to allow for the delivery of a baby. In some pregnancies, however, the cervix softens and dilates prematurely, leading to preterm birth. Bioengineers have addressed and continue to address the lack of reduction in preterm birth rates by developing novel technologies to diagnose, prevent, and understand premature cervical remodeling. This article highlights these existing and emerging technologies and concludes with open areas of research related to the cervix and preterm birth that bioengineers are currently well-positioned to address.
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Affiliation(s)
- Kyoko Yoshida
- Department of Biomedical Engineering, University of Minnesota, 7-105 Nils Hasselmo Hall, 312 Church Street SE, Minneapolis, MN, 55455, USA
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Zhang HP, Wu JJ, Zhang WY, Tao JZ, Ma CB, Zhou YQ. Evaluation of the stiffness of normal cervix and its change with different factors using transvaginal two-dimensional shear wave elastography under strict quality control. BMC Med Imaging 2023; 23:65. [PMID: 37217872 DOI: 10.1186/s12880-023-01020-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND The usefulness of transvaginal two-dimensional shear wave elastography (2D SWE) for cervical lesions is still uncertain. This study was to explore the value of transvaginal 2D SWE in the evaluation of the stiffness of normal cervix and its change with different factors under strict quality control (QC). METHODS Two hundred patients with normal cervix were included in this study and were examined using quantitative 2D SWE to evaluate cervical stiffness and its change with different factors under strict QC. RESULTS Intra-observer concordance of transvaginal 2D SWE parameters in midsagittal planes were acceptable with intraclass correlation coefficients higher than 0.5. Transvaginal 2D SWE parameters were significantly higher than the corresponding transabdominal parameters. 2D SWE parameters of internal cervical os were significantly higher than the corresponding parameters of external cervical os in a transvaginal midsagittal plane. 2D SWE parameters of external cervical os increased significantly over 50 years old, while these parameters of internal cervical os didn't change significantly with increasing age. 2D SWE parameters of internal cervical os of horizontal position cervix were significantly higher than those of vertical position cervix. SWE parameters of normal cervix did not change according to different menstrual cycles, parities and human papilloma virus test results. CONCLUSIONS Transvaginal 2D SWE under strict QC could provide quantitative, repeatable and reliable cervical stiffness information. Internal cervical os was stiffer than external cervical os. Menstrual cycles, parities and human papilloma virus test results wouldn't affect cervical stiffness. However, age and cervical positions should be taken into condition while interpreting 2D SWE results of cervical stiffness.
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Grants
- 19ZR1441500 natural science foundation of Shanghai, China
- 22ZR1458200 natural science foundation of Shanghai, China
- CNKW2020Z04 key program of science and technology commission foundation of Changning district, Shanghai, China
- CNKW2020Z04 key program of science and technology commission foundation of Changning district, Shanghai, China
- CNKW2020Z04 key program of science and technology commission foundation of Changning district, Shanghai, China
- CNKW2020Z04 key program of science and technology commission foundation of Changning district, Shanghai, China
- RCJD2021B09 medical PhD innovative talent base project of Changning district, Shanghai, China
- RCJD2021B09 medical PhD innovative talent base project of Changning district, Shanghai, China
- RCJD2021B09 medical PhD innovative talent base project of Changning district, Shanghai, China
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Affiliation(s)
- Hui-Ping Zhang
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, 200050, China
| | - Jing-Jing Wu
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, 200050, China
| | - Wen-Ying Zhang
- Department of Gynecology, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, 200050, China
| | - Jiu-Zhi Tao
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, 200050, China
| | - Cheng-Bin Ma
- Department of Gynecology, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, 200050, China
| | - Yu-Qing Zhou
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, 200050, China.
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Yang X, Ding Y, Mei J, Xiong W, Wang J, Huang Z, Li R. Second-Trimester Cervical Shear Wave Elastography Combined With Cervical Length for the Prediction of Spontaneous Preterm Birth. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:820-829. [PMID: 35272890 DOI: 10.1016/j.ultrasmedbio.2022.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/06/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
The goal of this study was to explore the value of shear wave elastography (SWE) combined with cervical length (CL) in the prediction of spontaneous preterm birth (sPTB) between 18 and 24 weeks of gestation. In this study, SWE was used to evaluate four regions of the cervix: the external and anterior lip (region A1), the external and posterior lip (region A2), the internal and anterior lip (region A3) and the internal and posterior lip (region A4). The cervical Young's modulus (YM) was compared between women who spontaneously delivered prematurely (<37 wk) and those who delivered full term. Finally, the predictive power of SWE was evaluated using receiver operating characteristic analysis. Overall, 773 patients were included in this study, of whom 60 (7.8%) had a sPTB. In the univariate analysis, prior sPTB, history of spontaneous abortion, history of cervical surgery, CL and YM at the anterior portion of both the internal and external os and the posterior portion of the internal os were associated with sPTB (p < 0.05). Multiple regression analyses were performed to develop the prediction probability for sPTB. YM and CL were independent predictors of sPTB in asymptomatic women, and the combination of YM and CL improved the ability to predict sPTB (area under the receiver operating characteristic curve = 0.98, 95% confidence interval: 0.97-0.99, p < 0.001). The interventions had relatively little impact on the outcome indicators measured. Cervical YM added to the CL may improve the predictive performance of second-trimester transvaginal ultrasound for sPTB.
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Affiliation(s)
- Xiaofeng Yang
- First Affiliate Hospital of Jinan University, Guangzhou, China
| | - Yuzhen Ding
- First Affiliate Hospital of Jinan University, Guangzhou, China
| | - Jie Mei
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Wen Xiong
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Jingyun Wang
- First Affiliate Hospital of Jinan University, Guangzhou, China
| | - Zhengrui Huang
- First Affiliate Hospital of Jinan University, Guangzhou, China
| | - Ruiman Li
- First Affiliate Hospital of Jinan University, Guangzhou, China.
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Woo J, Ge W, Mancheri J, Hyett J, Mogra R. Shear wave elastography: the relationship of the cervical stiffness with gestational age and cervical length- a feasibility study. J Matern Fetal Neonatal Med 2022; 35:9684-9693. [PMID: 35337244 DOI: 10.1080/14767058.2022.2050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To standardize the measurement of shear wave elastography for assessment of cervical stiffness and its relationship with gestational age and cervical length. METHODS A prospective cross-sectional study was conducted from September 2017 to March 2019. Data from 125 unselected women (at 11-13 + 6, 18-22 and 24-28 weeks' gestation) and 55 high-risk women were analyzed for the study. Six regions of interest were evaluated for cervical elastography in the mid-sagittal position by transvaginal ultrasound. Statistical analyses were performed using R statistical language in R-studio. Delivery outcomes were recorded for each patient. RESULTS The shear wave elastography was feasible with good intraoperator and interoperator reproducibility. The endocervical canal and anterior lip internal position had the highest reproducibility (ICC-0.82, 0.75). Shear wave speed was significantly higher in all internal os regions than the external os. There was a statistically significant negative linear relationship of shear wave speed with the gestational age. There was a weak positive relationship between shear wave speed and cervical length. There was no difference between pregnancies with and without spontaneous preterm delivery in shear wave speed measurements and cervical length, although numbers were small for statistical analysis. The internal os of the large loop excision of the transformation zone group was stiffer than the normal population. CONCLUSION Cervical elastography is feasible and effectively evaluates the tensile properties of the cervix during pregnancy. The most reproducible measurements were obtained at the anterior lip of the internal cervical os. Combining evaluation of cervical elasticity and length might further improve the identification of women at risk of preterm delivery. Currently, technical issues hinder the practical application of shear wave elastography in the clinical setting and require further research and development of the imaging modality.
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Affiliation(s)
- Joyce Woo
- Sydney Institute for Women, Children and their Families, Sydney, Australia
| | - Weirong Ge
- Royal Prince Alfred Hospital, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney, Australia
| | - Jyothi Mancheri
- Sydney Institute for Women, Children and their Families, Sydney, Australia
| | - Jon Hyett
- Royal Prince Alfred Hospital, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney, Australia
| | - Ritu Mogra
- Royal Prince Alfred Hospital, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney, Australia
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Sun J, Li N, Jian W, Cao D, Yang J, Chen M. Clinical application of cervical shear wave elastography in predicting the risk of preterm delivery in DCDA twin pregnancy. BMC Pregnancy Childbirth 2022; 22:202. [PMID: 35287624 PMCID: PMC8919632 DOI: 10.1186/s12884-022-04526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Limited studies have used cervical shear wave elastography (SWE) as a tool to investigate the predictive effect of cervical changes on preterm delivery (PTD) in twin pregnancy. This study is aimed to predict the risk of PTD by cervical SWE in dichorionic diamniotic (DCDA) twin pregnancy. Methods A total of 138 women with dichorionic diamniotic (DCDA) twins were included in this prospective study. The mean SWE value of the cervix was obtained from the inner, middle and outer regions of the anterior and posterior cervical lips using a transvaginal ultrasound transducer and measured consecutively across three different gestations (20–23+ 6 weeks, 24–27+ 6 weeks, and 28–32 weeks). Follow-up was performed on all subjects, and we compared the mean SWE value between the PTD and term delivery (TD) groups. Results A total of 1656 cervical mean SWE data were collected for analysis. Among the 138 twin pregnant women, only 92 women completed the three elastography examinations; PTD occurred in 58.7% (54/92), and TD in 41.3% (38/92). The mean (SD) maternal age was 33.1 ± 4.1 years, and the mean (SD) body mass index was 21.1 ± 2.6 kg/m2. As gestational age increased, the mean SWE value of each part of the cervix decreased. The cervical mean SWE value was lower in the preterm group than in the term group in all three gestations, except for the anterior cervical lip at 28–32 weeks. Receiver operating characteristics (ROC) curves showed the sensitivity of mean SWE value of the anterior cervical lip was 83.3% (95% CI, 70.7–92.1) with a specificity of 57.9% (95% CI, 40.8–73.7) for predicting PTD at a cutoff value of 7.94 kPa. The positive likelihood ratio (LR+) was 1.67 (95% CI, 1.19–2.34), and the negative likelihood ratio (LR–) was 0.33 (95% CI, 0.17–0.64). Conclusions There is a significant negative correlation between cervical stiffness and gestational age in DCDA twin pregnancy. SWE is a potential tool for assessing cervical stiffness and predicting PTD in DCDA twin pregnancy. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04526-0.
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Affiliation(s)
- Jimei Sun
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Nan Li
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Wei Jian
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Dingya Cao
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Junying Yang
- Global UIS Academic Department, Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Shenzhen, China
| | - Min Chen
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China.
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11
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Diagnosis and Analysis of Transabdominal and Intracavitary Ultrasound in Gynecological Acute Abdomen. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2021:9508838. [PMID: 35003327 PMCID: PMC8731280 DOI: 10.1155/2021/9508838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/08/2021] [Accepted: 11/22/2021] [Indexed: 01/30/2023]
Abstract
In order to explore the effective diagnosis method of gynecological acute abdomen, this paper takes hospital gynecological acute abdomen patients as samples and selects gynecological acute abdomen patients admitted to the hospital to be included in this study. They are divided into transabdominal ultrasound group, intracavitary ultrasound group, and combined group. Moreover, this paper uses mathematical statistics to carry out sample statistics. The statistical data mainly include ectopic pregnancy, torsion of ovarian tumor pedicle, acute suppurative salpingitis, torsion of fallopian tube, hemorrhagic salpingitis, acute pelvic inflammatory disease, rupture of corpus luteum cyst, and diagnosis accuracy rate. In addition, this paper compares the diagnostic accuracy of the abdominal ultrasound group, the intracavitary ultrasound group, and the combined group. The experimental research shows that the combined ultrasound diagnosis method can effectively improve the accuracy of the diagnosis of gynecological acute abdomen.
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Vora Z, Manchanda S, Sharma R, Das CJ, Hari S, Mathur S, Kumar S, Kachhawa G, Khan MA. Transvaginal Shear Wave Elastography for Assessment of Endometrial and Subendometrial Pathologies: A Prospective Pilot Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:61-70. [PMID: 33645765 DOI: 10.1002/jum.15679] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the role of shear wave elastography (SWE) in characterizing different endometrial and subendometrial pathologies. METHODS Seventy-three women with pathologically proven endometrial and subendometrial pathologies were enrolled in this prospective study and assessed with transvaginal SWE. The elasticity values (in kiloPascals), and the ratio of mean elasticity of the endometrial lesion to myometrial elasticity (E/M ratio) were compared in different pathologies. RESULTS There was a statistically significant difference (P <.001) in the mean, minimum, and maximum elasticity of the pathologies as well as the E/M ratio (P <.00001). In the analysis of the subgroups, the mean elasticity of endometrial polyp was statistically significantly lower than other subgroups (P <.01), while submucosal leiomyoma and focal adenomyoma had significantly higher values than other subgroups (P <.01). No statistically significant difference was noted in the mean elasticity of carcinoma and hyperplasia (P-.19). CONCLUSION SWE is a potential adjunct to ultrasound that provides an additional paradigm to characterize endometrial and subendometrial masses.
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Affiliation(s)
- Zainab Vora
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Hari
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunesh Kumar
- Department of Gynaecology-Obstetrics, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Gynaecology-Obstetrics, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof Ahmad Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Zhang M, Townsel CD, Akers LB, Kiros L, Treadwell MC, Maturen KE. Biomechanical Cervical Assessment Using 2-Dimentional Transvaginal Shear Wave Elastography in Nonpregnant and Pregnant Women: A Prospective Pilot Study. Ultrasound Q 2021; 37:183-190. [PMID: 34057917 DOI: 10.1097/ruq.0000000000000561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
ABSTRACT This study evaluated the technical feasibility of 2-dimensional transvaginal shear wave elastography to quantify cervical stiffness in nonpregnant and pregnant women and established normal values in each group. With institutional review board approval, we performed a prospective study with an age-matched historical control design. Sixteen premenopausal nonpregnant women without cervical pathology and 17 low-risk pregnant women (gestational age 17-33 weeks) were enrolled. Cervical shear wave speeds were measured on a SuperSonic Aixplorer machine. The mean shear wave speeds of anterior cervix were 4.96 ± 1.96 m/s in nonpregnant women and 1.92 ± 0.31 m/s in pregnant women. No significant stiffness difference was found between the anterior and posterior cervix (P = 0.15). The upper cervix was stiffer than the lower cervix in the pregnant women (P = 0.00012). Transvaginal shear wave elastography reveals that cervix at a midterm gestation is significantly softer than nonpregnant cervix (P < 0.0001) and suggests a spatial stiffness gradient along the length of the cervix, consistent with histopathology and limited elastography literature. Our results indicate the potential of transvaginal shear wave elastography to provide objective and quantitative estimates of cervical stiffness, especially during pregnancy.
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Affiliation(s)
| | | | | | - Leah Kiros
- Psychology, Michigan Medicine, University of Michigan, Ann Arbor, MI
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Bai X, Liu Z, Wang B. Shear Wave Elastography (SWE) Evaluation of Asymptomatic Flexor Pollicis Longus Tendon Condition After Volar Plate Fixation for Distal Radius Fracture. Int J Gen Med 2021; 14:187-193. [PMID: 33500654 PMCID: PMC7822231 DOI: 10.2147/ijgm.s290017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/04/2020] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to evaluate asymptomatic flexor pollicis longus (FPL) tendon condition after volar plate fixation for distal radius fracture using shear wave elastography (SWE). Methods We evaluated 36 distal radius fractures with shear wave elastography to evaluate the FPL tendon after volar plate fixation. Ultrasonography was used to measure the FPL distance to the volar plate in the involved wrists, and the thickness of the FPL tendon in the involved wrists was measured on SWE sonograms taken 12 months postoperatively. Measurements of the involved wrists were compared with those of the intact wrists. The radiographic parameters and Soong grade were collected to analyze the correlation between these indicators and the value of the Young’s modulus and asymptomatic tendon injury. Results The mean values of the Young’s modulus for involved wrist were lower than for intact wrist tendons. The values of the Young’s modulus were correlated with the FPL distance, radial inclination, and Soong grade. FPL tendons of involved wrists exhibited in the majority a yellow (intermediate) SWE signal, compared to intact wrist tendons, which exhibited a red (hard) signal in the vast majority, and there were significant differences between the involved and intact wrist. Conclusion FPL tendon may develop asymptomatically changes after volar locking plate fixation of distal radius fractures, which can be detected by SWE effectively. FPL distance, radial accretion, and Soong grade may be the main causes of asymptomatic FPL tendon erosion.
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Affiliation(s)
- Xiaodong Bai
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People's Republic of China
| | - Zhenyu Liu
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People's Republic of China
| | - Baojun Wang
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People's Republic of China
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Li X, Li L, Li Y, Fang S, Zhao C, Zhang Y, Yang Z. USEFULNESS OF TRANSPERINEAL VIRTUAL TOUCH QUANTIFICATION IN THE CERVIX FOR PREDICTING OUTCOME OF LABOR INDUCTION. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2207-2214. [PMID: 32565129 DOI: 10.1016/j.ultrasmedbio.2020.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to explore the feasibility of transperineal virtual touch tissue quantification (VTQ) for predicting the outcome of labor induction. A total of 80 nulliparous pregnant women were included. Before labor induction, cervical length was measured by B-mode sonography, cervical stiffness was measured by VTQ, and Bishop score was assessed by vaginal examination. Subsequently, labor was induced using standard oxytocin infusion in all patients. Delivery within 24 hours after labor induction was classified as spontaneous delivery; otherwise, cesarean delivery was performed. Out of 80 participants, 48 (60%) delivered vaginally and 32 (40%) underwent cesarean delivery. The cervical length was significantly longer and the shear wave velocity (SWV) was greater in the cesarean delivery group than in the vaginal delivery group (p = 0.004 and p < 0.000, respectively). Logistic regression analysis indicated that only the mean SWV had independent predictive value for the outcome of labor induction (p = 0.011). The best diagnostic cut-off point of the mean SWV was 1.23 m/s, with a sensitivity of 93.8% and a specificity of 89.6%. Transperineal VTQ technique could predict the outcome of labor induction using oxytocin.
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Affiliation(s)
- Xiumei Li
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Li Li
- Department of Ultrasound, Rizhao People's Hospital, Rizhao 276500, Shandong, China
| | - Yong Li
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Shibao Fang
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Cheng Zhao
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Yongchun Zhang
- Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China
| | - Zongli Yang
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 276003, Shandong, China.
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Diawtipsukon S, Bumrungphuet S, Dulyaphat W, Panburana P. <p>The Comparative Study of Cervical Shear Wave Elastography Between Twin and Singleton Pregnancy</p>. Int J Womens Health 2020; 12:649-656. [PMID: 32922090 PMCID: PMC7457743 DOI: 10.2147/ijwh.s251522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/22/2020] [Indexed: 01/18/2023] Open
Abstract
Objective To compare the cervical shear wave elastography (SWE) by using transvaginal ultrasound (TVS) between twin and singleton pregnant women. Materials and Methods This was a prospective cohort study involving the twin and singleton pregnant women who attended the antenatal care at Ramathibodi Hospital, Bangkok, Thailand. The participants who met the inclusion criteria were serially measured the shear wave speed (SWS) by using TVS at early, mid-, and third trimester. The changes in SWS with advancing gestational age between twin and singleton pregnancies were evaluated. The gestational age at delivery and spontaneous preterm delivery rate were also analyzed. Results A total of 36 twin pregnancies and 38 singleton pregnancies were analyzed. No significant difference in baseline characteristics, except the age of participants (twin pregnancies 33.1±4.6 years, singleton pregnancies 29.9±5.4 years, p-value = 0.006) was observed. The cervical SWS decreased with advancing gestational age in both twin and singleton pregnancy, but there was a statistically significant difference of cervical SWS at the lower point in mid-trimester (twin pregnancies 2.27±0.4, singleton pregnancies 2.71±0.6 m/s, p-value = 0.001). However, no significant difference in cervical SWS at the upper point and the lower point in the early and third trimester was demonstrated. Even though the gestational age at delivery between both groups revealed a significant difference (twin pregnancies 35.9±2.8, singleton pregnancies 37.6±2.9 wk., p-value = 0.008) but the spontaneous preterm delivery rate did not differ significantly (twin pregnancies 22.2%, singleton pregnancies 15.8%, p-value = 0.483). Conclusion The mid-trimester cervical SWS measurement at the lower point detects the difference in cervical softness between twin pregnancies and singleton pregnancies. The cervical SWS might be an additional option for monitoring the change in cervical softness in twin pregnancies.
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Affiliation(s)
- Sanpon Diawtipsukon
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sommart Bumrungphuet
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence: Sommart Bumrungphuet Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok10400, ThailandTel +66 2 201 1412 Email
| | - Wirada Dulyaphat
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Panyu Panburana
- Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Castro L, García-Mejido JA, Arroyo E, Carrera J, Fernández-Palacín A, Sainz JA. Influence of epidemiological characteristics (age, parity and other factors) in the assessment of healthy uterine cervical stiffness evaluated through shear wave elastography as a prior step to its use in uterine cervical pathology. Arch Gynecol Obstet 2020; 302:753-762. [PMID: 32712928 DOI: 10.1007/s00404-020-05671-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate stiffness changes occurring in the healthy uterine cervix according to age, parity, phase of the menstrual cycle and other factors by shear wave elastography (SWE). METHODS Evaluations of cervical speed and stiffness measurements were performed in 50 non-pregnant patients without gynaecological pathology using SWE transvaginal ultrasound. We performed the evaluation in the midsagittal plane of the uterine cervix with measurements at 0.5, 1 and 1.5 cm from external cervical os, at both anterior and posterior cervical lips. RESULTS We evaluated 44 patients by SWE and obtained a total average velocity of 3.48 ± 1.08 m/s and stiffness of 42.39 ± 25.33 kPa. We found differences in speed and stiffness according to the cervical lip and depth evaluated; thus, we observed a velocity of 2.70 m/s at 0.5 cm of depth in the anterior lip and 3.53 m/s at 1.5 cm of depth in the posterior lip (p < 0.05). We observed differences according to parity, obtaining a wave transmission speed of 2.67 m/s and 4.41 m/s at the cervical canal of nulliparous and multiparous patients, respectively (p < 0 0.002). We observed differences according to patient age (from a speed of 2.75 m/s at the cervical canal in the age group of 20-35 years to 5.05 m/s in the age group > 50 years) (p < 0.008). We did not observe differences in speed or stiffness according to the phase of the menstrual cycle, BMI, smoking status or the presence or absence of non-HPV infections. CONCLUSIONS The wave transmission speed and stiffness of the uterine cervix evaluated by SWE varies according to the cervical lip and depth of the evaluation as well as according to the parity and age of the patient.
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Affiliation(s)
- Laura Castro
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
| | - José Antonio García-Mejido
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain.
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain.
| | - Eva Arroyo
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
| | - Jara Carrera
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
| | - Ana Fernández-Palacín
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - José Antonio Sainz
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
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Duan H, Chaemsaithong P, Ju X, Ho SYS, Sun Q, Tai Y, Leung TY, Poon LC. Shear‐wave sonoelastographic assessment of cervix in pregnancy. Acta Obstet Gynecol Scand 2020; 99:1458-1468. [DOI: 10.1111/aogs.13874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/10/2020] [Accepted: 04/12/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Honglei Duan
- Department of Obstetrics and Gynecology Affiliated Drum Tower HospitalMedical School of Nanjing University Nanjing China
| | - Piya Chaemsaithong
- Department of Obstetrics and gynecology The Chinese University of Hong Kong Hong Kong SAR
| | - Xiaoqing Ju
- Department of Obstetrics and gynecology The Chinese University of Hong Kong Hong Kong SAR
| | - Sin Yee Stella Ho
- Department of Imaging and Interventional Radiology The Chinese University of Hong Kong Hong Kong Hong Kong SAR
| | - Qian Sun
- Department of Obstetrics The First Affiliated Hospital of Kunming Medical University Kunming China
| | - Yi‐yun Tai
- Department of Obstetrics and Gynecology National Taiwan University Hospital Taipei Taiwan
| | - Tak Yeung Leung
- Department of Obstetrics and gynecology The Chinese University of Hong Kong Hong Kong SAR
| | - Liona C. Poon
- Department of Obstetrics and gynecology The Chinese University of Hong Kong Hong Kong SAR
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Shear wave elastography of the uterine cervix under different conditions with inter-operator agreement analysis. Pol J Radiol 2020; 85:e245-e249. [PMID: 32612722 PMCID: PMC7315054 DOI: 10.5114/pjr.2020.95527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/19/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose Shear wave elastography (SWE) is a relatively new technique for measuring tissue elasticity. Its implementation for assessing the tissue of the cervix is evolving, and SWE analyses of healthy, nonpregnant cervixes is the first step in understanding other SWE changes related to cervical pathologies; nevertheless, some challenges in the use of the technique still require investigation. We aimed to target the consistency of healthy cervix shear wave elastography measurements and examine the changes induced by patient-related factors. Material and methods Elastograms were obtained at the internal and external os in the anterior (IA, EA) and posterior (IP, EP) portions of the cervix using a transvaginal approach in eight postmenopausal and 25 premenopausal women. Measurements with a standard deviation of over 20% and patients who presented with colour loss or heterogeneity were excluded from the study. Shear wave elastography assessments were performed using a Toshiba Aplio 500 version 6. Statistical significance was defined as a p value less than 0.10, due to the small number of patients. Results The mean speeds obtained at the external os on the anterior and posterior aspects was 3.17 ± 0.85 m/s and 3.18 ± 0.84 m/s, respectively, and at the internal os, the results on the anterior and posterior aspects were 3.38 ± 0.73 m/s and 3.53 ± 0.81 m/s, respectively. The difference in speed among all regions was statistically significant (p < 0.05). Fifteen patients were also analysed by a second radiologist with a similar experience level as that of the first. Nine measurements for IP, 13 measurements for IA, 11 measurements for EP, and 15 measurements for EA were performed. The correlation coefficients between the two sets of measurements were 0.46, 0.30, 0.67, and 0.51, respectively. There was no difference in the SWE values with respect to age, parity, and gravidity for any of the regions. The SWE values at the IA, IP, and EA regions between the postmenopausal and premenopausal women were significantly different (p = 0.038, p = 0.059, p = 0.065). Conclusions The posterior portion of the internal os is most likely to undergo inaccurate SWE measurement among the different anatomical positions. The correlation between radiologists was found to be different for different locations in the cervix. More studies are needed to determine the SWE values of the healthy cervix and the agreement levels between radiologists.
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Cervical Assessment by Transvaginal Ultrasound for Predicting Preterm Birth in Asymptomatic Women. MATERNAL-FETAL MEDICINE 2020. [DOI: 10.1097/fm9.0000000000000043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Jiao Y, Xue N, Zou C, Shui X, Wang H, Hu C. Assessment of early damage of endometrium after artificial abortion by shear wave elastography. Insights Imaging 2020; 11:28. [PMID: 32128718 PMCID: PMC7054526 DOI: 10.1186/s13244-020-0841-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/30/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the application of shear wave elastography (SWE) in the early damage detection through assessing the endometrial elasticity after artificial abortion. METHODS A total of nulliparous women (20-30 years) who received ultrasonography in our hospital were recruited between January 2017 and December 2017. These women were divided into normal control group (NC; n = 65), after once artificial abortion group (AOAA; n = 68), after twice artificial abortion group (ATAA; n = 61), and after three times or more (range, 3-6) artificial abortion group (ATTMAA; n = 60). SWE was performed to evaluate the endometrium; Young's modulus of the endometrium was determined and then the endometrial thickness was measured. RESULTS Young's modulus of the endometrium increased in the order of NC group, AOAA group, ATAA group, and ATTMAA group, and Young's modulus increased with the increase in the number of artificial abortions (p < 0.05). The endometrial thickness in the ATTMAA group was significantly lower than in the NC group, AOAA group, and ATAA group (p < 0.05), but there was no marked difference among the NC group, AOAA group, and ATAA group (p > 0.05). CONCLUSIONS SWE increases with increasing number of abortions, which may indicate the damage that is done to the endometrium earlier than measurement of the endometrial thickness do.
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Affiliation(s)
- Yan Jiao
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215006, China
- Obstetrics and Gynecology Ultrasonic Department, Wenzhou Peoples' Hospital, Wenzhou, 325000, China
| | - Nianyu Xue
- Department of Diagnostic Ultrasonography, Ningbo First Hospital, Ningbo, 315010, China
| | - Chunpeng Zou
- Department of Diagnostic Ultrasonography, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xujuan Shui
- Obstetrics and Gynecology Ultrasonic Department, Wenzhou Peoples' Hospital, Wenzhou, 325000, China
| | - Hongqing Wang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215006, China.
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Manchanda S, Vora Z, Sharma R, Hari S, Das CJ, Kumar S, Kachhawa G, Khan MA. Quantitative Sonoelastographic Assessment of the Normal Uterus Using Shear Wave Elastography: An Initial Experience. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:3183-3189. [PMID: 31077426 DOI: 10.1002/jum.15019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/08/2019] [Accepted: 04/18/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To describe the sonoelastographic characteristics of the normal endometrium, myometrium, and cervix and to assess their variability with age and different menstrual phases. METHODS A total of 56 women were enrolled in this prospective study, who underwent transvaginal ultrasound examinations, including B-mode imaging and shear wave elastography. The elasticity parameters (in kilopascals) of the normal endometrium, myometrium, and cervix were studied. The variability of the mean elasticity value of the endometrium in different menstrual phases and age groups was analyzed. The variability of the mean elasticity of the cervix across different age groups was also studied. RESULTS The mean age of the participants was 40 years (range, 25-69 years). The normal mean elasticity values ± SDs were 25.54 ± 8.56 kPa for the endometrium, 40.24 ± 8.59 kPa for the myometrium, and 18.90 ± 4.22 kPa for the cervix. A mean endometrial-to-myometrial elasticity ratio was calculated, which was found to be 0.65 ± 0.22. There was no significant difference in the mean endometrial elasticity values for women in different menstrual phases (P = .176) or in different age groups (P = .376). There was no significant difference in the mean cervical elasticity with age (P = .192). CONCLUSIONS Shear wave elastography is a promising adjunct to ultrasound for the evaluation of the uterus, and the results from this study may provide normal data, which may further help in diagnosing various uterine diseases.
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Affiliation(s)
- Smita Manchanda
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Zainab Vora
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Hari
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sunesh Kumar
- Department of Gynecology and Obstetrics, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Gynecology and Obstetrics, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof Ahmad Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Suthasmalee S, Moungmaithong S. Cervical shear wave elastography as a predictor of preterm delivery during 18–24 weeks of pregnancy. J Obstet Gynaecol Res 2019; 45:2158-2168. [DOI: 10.1111/jog.14094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/28/2019] [Indexed: 12/20/2022]
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Horinouchi T, Yoshizato T, Muto M, Fujii M, Kozuma Y, Shinagawa T, Morokuma S, Kakuma T, Ushijima K. Gestational age-related changes in shear wave speed of the uterine cervix in normal pregnancy at 12-35 weeks' gestation. J Perinat Med 2019; 47:393-401. [PMID: 30817303 DOI: 10.1515/jpm-2018-0250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/21/2019] [Indexed: 02/06/2023]
Abstract
Background This study aimed to analyze age-related changes in shear wave speed (SWS) of the normal uterine cervix. Methods We studied 362 women with a normal singleton pregnancy at 12-35 weeks' gestation. The SWS of the cervix was measured using transvaginal ultrasonography at the internal os region of the anterior cervix (IOA), posterior cervix (IOP) and cervical canal (IOC), and at the external os region of the anterior cervix (EOA), posterior cervix (EOP) and cervical canal (EOC). The following parameters were analyzed: (1) time trend of SWS of the individual sampling points, (2) comparison of SWS in the internal cervical region and SWS in the external cervical region, and (3) comparison of SWS between the internal and external cervical regions. Statistical analyses were performed using mixed-effects models. Results The SWS of IOP decreased in bilinear regression, with a critical change in the rate at 22 weeks, whereas the SWS of the remaining points decreased linearly. The estimated values of SWS of IOP at 84, 154 and 251 days were higher than those of IOA and IOC (P<0.001). The estimated values of SWS of IOP at 84 and 154 days were higher than those of EOP (P<0.001). Significant differences between IOP and EOP were shown until 244 days (P<0.05). The estimated value of SWS of IOC at 84 days was higher than that of EOC (P<0.001). Significant differences between IOC and EOC were shown until 210 days (P<0.05). Conclusion The SWS of the uterine cervix in pregnancy decreases with advancing gestation. The SWS of IOP had the highest value among the sampling points with unique characteristics.
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Affiliation(s)
- Takashi Horinouchi
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Toshiyuki Yoshizato
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Megumi Muto
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Masahiro Fujii
- Department of Biostatistics, School of Medicine, Kurume University, Kurume, Japan
| | - Yutaka Kozuma
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Takaaki Shinagawa
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- Department of Biostatistics, School of Medicine, Kurume University, Kurume, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
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