经阴道宫颈剪切波弹性成像预测早产  

Transvaginal cervical shear wave elastography for evaluating preterm birth

作　　者：李凌 熊雯[1] 陈琴[1] 刘芸[1] 梅劼[2] 杨小锋 周青[1] LI Ling;XIONG Wen;CHEN Qin;LIU Yun;MEI Jie;YANG Xiaofeng;ZHOU Qing(Department of Ultrasound,Sichuan Academy of Medical Sciences&Sichuan Province People's Hospital,Chengdu 610072,China;Department of Obstetrics and Gynecology,Sichuan Academy of Medical Sciences&Sichuan Province People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院•四川省人民医院超声科,四川成都610072 [2]四川省医学科学院•四川省人民医院妇产科,四川成都610072

出　　处：《中国介入影像与治疗学》2021年第7期406-410,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察经阴道宫颈剪切波弹性成像对早产的预测价值。方法选取接受常规产前超声检查的140名孕妇,于孕18~24周经阴道超声测量宫颈管长度,而后启用剪切波弹性成像测量宫颈内口前唇、后唇及宫颈外口前唇、后唇弹性值。追踪妊娠结局,以妊娠满28周、不足37周分娩为早产标准分为早产及足月产,采用受试者工作特征(ROC)曲线分析宫颈管长度及宫颈弹性值对早产的预测价值。结果140名孕妇中,2例因母胎因素于37周前终止妊娠,1例失访,均予以排除,最终纳入137名;其中24名早产(早产组),113名足月产(足月产组),组间宫颈管长度及宫颈内口前唇、后唇及外口前唇弹性值差异均有统计学意义(P均<0.05),宫颈外口后唇弹性值差异无统计学意义(P>0.05)。ROC曲线结果显示,宫颈内口前唇、宫颈内口后唇弹性值及宫颈管长度预测早产的ROC曲线下面积(AUC)分别为0.87、0.86和0.73,宫颈内口前唇或后唇联合宫颈管长度预测早产的AUC均为0.88。结论经阴道宫颈剪切波弹性成像可用于预测早产。Objective To explore the value of transvaginal cervical shear wave elastography in prediction premature birth.Methods A total of 140 pregnant women who underwent prenatal ultrasonic examinations were enrolled.Cervical canal lengths were measured at 18-24 weeks of gestation,and then shear wave electrography was used to measure the elasticity of anterior and posterior lips of the internal cervical opening,anterior and posterior lips of the external cervical opening.Pregnancy outcomes were followed up and recorded,and delivery at 28-37 weeks of gestation was taken as the diagnostic criteria for preterm delivery,and the pregnant women were divided into preterm delivery group and the term group.The predictive value of cervical canal length and elasticity value on preterm delivery were analyzed with receiver operating characteristic(ROC)curves.Results Among 140 pregnant women,terminated pregnancy before 37 weeks due to maternal-fetal factors occurred in 2 cases,while 1 was lost to follow-up,and the above 3 cases were excluded.Among 137 pregnant women,premature and full-term delivery occurred in 24 and 113 ones,respectively.Statistical differences of cervical canal length,elastic values of the anterior and posterior lips of the internal cervical opening and the anterior lip of the external cervical opening were found between groups(all P<0.05),while there was no statistical difference in the elastic values of the posterior lip of the external cervical opening(P>0.05).ROC curve showed that the area under the curve(AUC)of the posterior lip,the elasticity value of the anterior lip and the cervical length in predicting premature birth was 0.87,0.86 and 0.73,respectively.AUC of the anterior lip or the posterior lip combined with the cervical length in predicting premature birth were all 0.88.Conclusion Transvaginal cervical shear wave elastography could be used to predict preterm birth.

关 键 词：早产 子宫颈 超声检查 弹性成像技术 

分 类 号：R714.1[医药卫生—妇产科学] R445.1[医药卫生—临床医学]