Abstract
Strain elastography of the uterine cervix may be useful in the diagnosis and prediction of obstetric complications. The inability to obtain quantitative results, with only the possibility of visual semiquantitative evaluation of the obtained elastograms, has been the limitation of the method thus far. E-Cervix is a software program that uses intrinsic compression to excite tissue and allows the evaluation of quantitative parameters on the basis of pixel distribution in an elastogram. The aim of this study was to assess the repeatability and reproducibility of quantitative cervical strain elastography (E-Cervix) of the uterine cervix and to assess the correlation of the obtained parameters with selected clinical features of patients in the third trimester of pregnancy. In total, 222 patients participated in the study. We assessed 5 ultrasound parameters: elasticity index (ECI), hardness ratio (HR), internal os strain (IOS), external os strain (EOS) and IOS/EOS ratio. Each study was performed according to a predetermined standardized protocol. For all assessed elastographic parameters, we obtained good intra- and interobserver reproducibility. The interclass correlation coefficient (ICC) ranged from 0.77 to 0.838 for intraobserver variability and from 0.771 to 0.826 for interobserver variability. We demonstrated a significant correlation of some obtained elastographic parameters with the basic clinical features of patients, such as age, the number of previous caesarean sections, pregnancy weight and BMI. In each case, the correlation was very low. Quantitative elastographic assessment with the use of E-Cervix is characterized by good repeatability. Some clinical features may affect the value of the parameters obtained. The clinical relevance of this interference requires further investigation.
Highlights
Ultrasound elastography (USE) of human organs has already found its use in many medical specializations
The cervix is examined with the use of strain elastography (SE)—in which the necessary vibrations of the tissue are excited by intrinsic factors—mainly due to the pulse wave of the pelvic vessels carried by the surrounding t issues[8]
A total of 222 Caucasian patients were enrolled in the study: 125 patients in the group assessing intraobserver variability (79 for rater A and 46 for rater B) and 97 patients in the group assessing interobserver variability
Summary
Ultrasound elastography (USE) of human organs has already found its use in many medical specializations. The E-Cervix (Samsung Medison), a semiautomatic system for the elastographic evaluation of the cervix, meets the expectations of the quantitative approach to the elastogram. In this method, the cervix is examined with the use of SE—in which the necessary vibrations of the tissue are excited by intrinsic factors—mainly due to the pulse wave of the pelvic vessels carried by the surrounding t issues[8]. The number of red pixels (defined as the top 30% of the colour intensity scale) among all of the pixels in the ROI This value is displayed as a percentage (0%-soft, 100%-hard).
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