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. 2023 May 22;23(1):65.
doi: 10.1186/s12880-023-01020-7.

Evaluation of the stiffness of normal cervix and its change with different factors using transvaginal two-dimensional shear wave elastography under strict quality control

Hui-Ping Zhang  1 , Jing-Jing Wu  1 , Wen-Ying Zhang  2 , Jiu-Zhi Tao  1 , Cheng-Bin Ma  2 , Yu-Qing Zhou  3
Affiliations

Evaluation of the stiffness of normal cervix and its change with different factors using transvaginal two-dimensional shear wave elastography under strict quality control

Hui-Ping Zhang et al. BMC Med Imaging. .

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.

Keywords: Cervix; Quality control; Shear wave elastography; Transvaginal ultrasound; Two-dimension.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Different cervical positions. (a) A cervix with a vertical position. (b) A cervix with a horizontal position
Fig. 2
Fig. 2
Two-dimensional shear wave elastography image under strict quality control with reliability index (RLB index) shown on the left as 100% and motion stability index (M-STB index) shown on the right as 5 green stars
Fig. 3
Fig. 3
ROI drawing shown in the same figure in Fig. 2. Two circular ROIs with same diameter as 5 mm were put at internal and external cervical os respectively. Quantitative parameters as Emean (mean elasticity), Emax (maximal elasticity) and Emin (minimal elasticity) of each ROI were shown on the screen. ROI: region of interest
See this image and copyright information in PMC

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