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• W2042180103 abstract "A reliable diagnostic tool for the early identification of cervical insufficiency would be highly desirable. Numerous studies have demonstrated that the length of the cervix decreases during the course of pregnancy, while its width increases. Moreover, it has been shown that the probability of premature delivery increases when the cervix is short during the second trimester and the internal os is wide (funneling)1-5. Based on the assumption that premature cervical softening and premature delivery constitute a multifactorial process, we hypothesized that there may be underlying gestational and/or maternal age-related changes in tissue elasticity. Tissue elasticity can be determined from stretching and compression parameters of a tissue of interest. While stretching values can be derived directly from high-frequency echo signals, compression values cannot be determined directly. This is why assessment of compression should be performed under standardized conditions. Advances have been achieved through the advent of real-time sonoelastography6. This technique generates images in which the elasticity values are superimposed in color on conventional B-mode images in real time. The technique is similar to color Doppler and does not lengthen the scan time. Initial results with this new technique for different organ systems are very promising7-10. Based on these results, we have begun to investigate whether elastography can be used to identify typical changes in cervical tissue elasticity that correlate with the week of gestation or the age of the pregnant woman. Using a high-end ultrasound device (Hitachi EUB-8500, Wiesbaden, Germany), measurements of tissue elasticity were performed using the same probe as that used for transvaginal B-mode imaging. A region of interest was selected and the elasticity information presented in color with blue indicating harder tissue and red deformable, soft tissue (Figure 1). Elastography measures echo frequency patterns along the ultrasound beam over time before and after compression of a tissue area. At the same time, the echo frequency waves of neighboring ultrasound waves can be compared in order to take lateral deviations around the tissue area into account. This involves use of the so-called extended combined autocorrelation method, which allows for more precise calculations after compression because it takes into account tissue displacement in all spatial directions and can be applied immediately. (a) Cervical elastography in a woman at 28 weeks' gestation showing intermediate tissue elasticity (green) surrounding the soft cervical canal (red-yellow). (b) B-mode image of the same cervix. Three basic colors of the elasticity spectrum are present in the cervix (green, red and blue). The percentages of red and green can be used to calculate an elasticity tissue quotient (TQ) using the formula: TQ = % red/% green. Correlation of the TQ with age and duration of pregnancy (week of gestation) showed, in our preliminary investigations, that TQ did not vary with the duration of pregnancy but that it did with maternal age. Our experience suggests that sonoelastography of the pregnant cervix is easy to perform and that it shows age-related differences in cervical elasticity. Future research will determine whether sonoelastography has the potential to provide insight into cervical insufficiency and premature delivery." @default.
• W2042180103 created "2016-06-24" @default.
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• W2042180103 date "2006-08-14" @default.
• W2042180103 modified "2023-10-09" @default.
• W2042180103 title "Imaging of the cervix using sonoelastography" @default.
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• W2042180103 doi "https://doi.org/10.1002/uog.3813" @default.
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