Objective To determine the reproducibility of the mean strain value in various cervical areas and new elastographic parameters for measuring cervical stiffness evaluated by strain elastography using in vivo compression generated by internal organ movement. Methods A prospective observational study (140 singleton pregnant women; 15-33 weeks of gestation) was performed at two tertiary centers. Cervical strain was evaluated using E-cervix™ elastography. The mean strain levels of various cervical areas [internal os (IOS), external os (EOS) and endocervical area] and several new parameters [i.e. the ratio of the strain level of IOS and EOS, elasticity contrast index (ECI), and hardness ratio] were assessed twice by two independent examiners. The inter-observer and intra-observer variances were calculated using the intraclass correlation coefficient (ICC) with a 95% confidence interval (CI). Bland-Altman (B-A) analysis was also performed. Results The median gestational age was 24.0 weeks, and the mean cervical length (CL) was 3.8 cm. The intra-observer and inter-observer ICCs of the mean strain levels of the specified cervical area and new elastographic parameters were statistically significant (P < 0.001, all); the intra-observer ICC was 0.639-0.725, and the inter-observer ICC was 0.538-0.718. Conclusion The reproducibility of elastographic parameter measurements using in vivo compression is improvable.

译文

目的确定各种颈椎区域的平均应变值的可重复性,以及通过使用内部器官运动产生的体内压缩通过应变弹性成像评估的用于测量颈椎刚度的新的弹性成像参数。方法在两个三级中心进行前瞻性观察性研究 (140名单胎孕妇; 妊娠15-33周)。使用电子子宫颈评估宫颈劳损™弹性成像。各种宫颈区域 [内部os (IOS),外部os (EOS) 和宫颈内膜区域] 的平均应变水平以及几个新参数 [即IOS和EOS的应变水平之比,弹性对比指数 (ECI),和硬度比] 由两名独立检查员评估两次。使用具有95% 置信区间 (CI) 的组内相关系数 (ICC) 计算观察者间和观察者内方差。还进行了Bland-Altman (b-a) 分析。结果中位胎龄为24.0周,平均宫颈长度 (CL) 为3.8厘米。指定颈部区域的平均应变水平和新的弹性成像参数的观察者内和观察者间ICCs具有统计学意义 (p  <  0.001,all); 观察者间ICC为0.639-0.725,观察者间ICC为0.538-0.718。结论使用体内压缩进行弹性成像参数测量的可重复性是可以改善的。

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