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Evaluation of cervical stiffness during pregnancy using semiquantitative ultrasound elastography.
MedLine Citation:
PMID:  23151941     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To evaluate cervical stiffness during pregnancy using ultrasound-derived elastography, a method used to estimate the average tissue displacement (strain) on a defined region of interest when oscillatory compression is applied. Methods. Strain was calculated in two regions of interest, the endocervical canal and the entire cervix, from three anatomical planes of the cervix: mid-sagittal in the plane used for cervical length measurement, and in cross-sectional planes located at the internal and external cervical os. Associations between strain values, method of ascertainment and patient characteristics were assessed using linear mixed models to account for within-subject correlation. Inter-rater agreement in defining the degree of cervical stiffness was evaluated in 120 regions of interest acquired by two operators in 20 patients. Results. A total of 1557 strain estimations were performed in 262 patients at 8-40 weeks of gestation. Adjusting for other sources of variation, 1) cervical tissue strain estimates obtained in the endocervical canal were on average 33% greater than those obtained in the entire cervix; 2) measures obtained in the cross-sectional plane of the external cervical os and sagittal plane were 45% and 13% greater compared to those measured in the cross-sectional plane of the internal cervical os, respectively; 3) mean strain rate was 14% and 5% greater among multiparous women with and without a history of preterm delivery compared to nulliparous women, respectively, and was on average 13% greater among women with a cervical length between 25-30mm compared to those with a cervical length >30mm; and 4) cervical tissue strain was more strongly associated with cervical length than with gestational age. Conclusion. Semiquantitative elastography can be employed to evaluate changes in cervical stiffness during pregnancy. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Edgar Hernandez-Andrade; Sonia S Hassan; Hyunyoung Ahn; Steven J Korzeniewski; Lami Yeo; Tinnakorn Chaiworapongsa; Roberto Romero
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, Michigan, USA; Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA. ehernand@med.wayne.edu.
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