Cervical Maturity Assessment Based on Ultrasound Elastography E-Cervix: Cluster Analysis.

IF 2.4 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2025-10-04 DOI:10.1002/jum.70078

Ekaterina V Kopteeva, Vladislava V Khalenko, Olga V Pachuliia, Olesya N Bespalova

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引用次数: 0

Abstract

Objective: To identify distinct cervical remodeling phenotypes based on ultrasound and quantitative elastography parameters using cluster analysis.

Methods: This single-center, prospective, observational study was conducted from February 2023 to January 2024 and included 373 pregnant women with singleton pregnancies between 6 + 0 and 41 + 0 weeks of gestation (total number of ultrasound examinations: 516). Cervical elastography was performed using the E-Cervix software (Samsung Medison, W10 system), with assessment of quantitative parameters (hardness ratio [HR], elasticity contrast index [ECI], internal os [IOS], external os [EOS]).

Results: Correlation analysis demonstrated that cervical hardness (HR) decreased, while tissue heterogeneity (ECI) and internal and external os deformation (IOS, EOS) increased with gestational age and cervical shortening. Cluster analysis identified three cervical phenotypes: the "immature cervix" phenotype had the greatest cervical length (37.4 mm [interquartile range 36.3-38.4]) and highest stiffness (HR 76.7% [75.7-77.7]), while the "mature cervix" phenotype showed the shortest length (24.1 mm [22.9-25.4]) and lowest stiffness (HR 38.1% [36.9-39.3]). Bishop scores differed significantly among the clusters (4, 6, and 8, respectively). The risk of spontaneous labor within 14 days was highest in the mature cervix group (HR 10.1, P < .001).

Conclusion: Decreasing HR and increasing ECI, IOS, and EOS indicate progressive cervical softening as pregnancy advances and the cervix shortens. The combination of elastography parameters and cervical length can be used to objectively assess cervical remodeling during pregnancy.

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基于超声弹性成像的宫颈成熟度评估：聚类分析。

目的：利用聚类分析方法，基于超声和定量弹性成像参数识别不同的颈椎重塑表型。方法：本研究于2023年2月至2024年1月进行单中心前瞻性观察性研究，纳入373例妊娠6 + 0 ~ 41 + 0周单胎妊娠孕妇（超声检查总次数516次）。采用E-Cervix软件（Samsung Medison， W10系统）进行颈椎弹性成像，并评估定量参数（硬度比[HR]、弹性对比指数[ECI]、内os [IOS]、外os [EOS]）。结果：相关分析显示，随着胎龄和宫颈缩短，宫颈硬度（HR）降低，组织异质性（ECI）和内外os变形（IOS、EOS）增加。聚类分析发现三种宫颈表型：“未成熟宫颈”表型的宫颈长度最大（37.4 mm[四分位数间距36.3-38.4]），硬度最高（HR 76.7%[75.7-77.7]），而“成熟宫颈”表型的长度最短（24.1 mm[22.9-25.4]），硬度最低（HR 38.1%[36.9-39.3]）。Bishop得分在集群之间差异显著（分别为4,6和8）。成熟子宫颈组14天内发生自然分娩的风险最高（HR 10.1， P）。结论：HR降低，ECI、IOS、EOS升高表明随着妊娠进展和子宫颈缩短，宫颈逐渐软化。弹性成像参数与宫颈长度的结合可客观评价妊娠期宫颈重构。

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

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound