Relationship between endometriosis and uterine cervical elasticity assessed using ultrasound strain elastography.

IF 2.4 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Ultrasonography Pub Date : 2024-11-01 Epub Date: 2024-09-02 DOI:10.14366/usg.24117

Anjeza Xholli, Filippo Molinari, Umberto Scovazzi, Ambrogio Pietro Londero, Isabella Perugi, Chiara Kratochwila, Francesca Cremonini, Angelo Cagnacci

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引用次数: 0

Abstract

Purpose: Internal cervical os (ICO) stiffness is related to menstrual pain, a key symptom of endometriosis. The study evaluated whether women with endometriosis have a stiffer ICO than unaffected women.

Methods: A retrospective cross-sectional analysis was conducted using prospectively collected data from women with and without endometriosis, spanning from June 2020 to September 2022. Endometriosis was diagnosed through clinical and ultrasound evaluations, with histological confirmation in a subset of participants. Strain elastography (SE) was employed to measure tissue elasticity in four cervical regions of interest: the ICO and the anterior, posterior, and middle cervical compartments (ACC, PCC, and MCC, respectively). Tissue elasticity was quantified using a color-based scoring system ranging from 0.1 (blue, indicating less elasticity) to 3.0 (red, indicating greater elasticity).

Results: Overall, 287 women were included, with 157 diagnosed with endometriosis and 130 controls. On SE, women with endometriosis exhibited a lower color score (mean±standard deviation), indicating lower elasticity, for the ICO (0.56±0.28 vs. 0.70±0.26, P=0.001) and PCC (0.69±0.30 vs. 0.80±0.27, P=0.002). Additionally, they had a lower ICO/MCC ratio (0.45±0.28 vs. 0.60±0.32, P=0.001) and ICO/ACC ratio (0.68±0.42 vs. 0.85±0.39, P=0.001). Multiple logistic regression analysis revealed that endometriosis was associated with the ICO color score (odds ratio, 0.053; 95% confidence interval, 0.014 to 0.202; R2=0.358; P=0.001), even after adjusting for confounding factors like the presence of myomas (P=0.040) and the use of hormonal therapy (P=0.001). The results were corroborated in women with histologically confirmed endometriosis (n=71).

Conclusion: The findings suggest a potential relationship between a stiffer ICO and endometriosis.

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利用超声应变弹性成像技术评估子宫内膜异位症与子宫颈弹性之间的关系。

目的：宫颈内口（ICO）僵硬与痛经有关，而痛经是子宫内膜异位症的一个主要症状。该研究评估了患有子宫内膜异位症的女性是否比未受影响的女性宫颈内口更僵硬：研究利用前瞻性收集的2020年6月至2022年9月期间患有和未患有子宫内膜异位症的女性数据进行了回顾性横断面分析。子宫内膜异位症是通过临床和超声波评估确诊的，并在一部分参与者中进行了组织学确认。应变弹性成像（SE）用于测量四个宫颈相关区域的组织弹性：宫颈内口（ICO）和宫颈前、后、中段（分别为 ACC、PCC 和 MCC）。采用基于颜色的评分系统对组织弹性进行量化，评分范围从 0.1（蓝色，表示弹性较小）到 3.0（红色，表示弹性较大）：总共有 287 名妇女参加了研究，其中 157 名被诊断为子宫内膜异位症，130 名为对照组。在 SE 中，患有子宫内膜异位症的妇女的 ICO（0.56±0.28 vs. 0.70±0.26，P=0.001）和 PCC（0.69±0.30 vs. 0.80±0.27，P=0.002）的颜色得分（平均值±标准偏差）较低，表明弹性较差。此外，他们的 ICO/MCC 比值（0.45±0.28 vs. 0.60±0.32，P=0.001）和 ICO/ACC 比值（0.68±0.42 vs. 0.85±0.39，P=0.001）也较低。多元逻辑回归分析显示，即使在调整了肌瘤存在（P=0.040）和使用激素治疗（P=0.001）等混杂因素后，子宫内膜异位症与 ICO 颜色评分仍有关联（几率比 0.053；95% 置信区间 0.014 至 0.202；R2=0.358；P=0.001）。经组织学证实患有子宫内膜异位症的妇女（71 人）也证实了这一结果：结论：研究结果表明，较硬的 ICO 与子宫内膜异位症之间存在潜在关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultrasonography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.10

自引率

6.50%

发文量

审稿时长

15 weeks

期刊介绍： Ultrasonography, the official English-language journal of the Korean Society of Ultrasound in Medicine (KSUM), is an international peer-reviewed academic journal dedicated to practice, research, technology, and education dealing with medical ultrasound. It is renamed from the Journal of Korean Society of Ultrasound in Medicine in January 2014, and published four times per year: January 1, April 1, July 1, and October 1. Original articles, technical notes, topical reviews, perspectives, pictorial essays, and timely editorial materials are published in Ultrasonography covering state-of-the-art content. Ultrasonography aims to provide updated information on new diagnostic concepts and technical developments, including experimental animal studies using new equipment in addition to well-designed reviews of contemporary issues in patient care. Along with running KSUM Open, the annual international congress of KSUM, Ultrasonography also serves as a medium for cooperation among physicians and specialists from around the world who are focusing on various ultrasound technology and disease problems and relevant basic science.