Magnetic resonance imaging of the cervix in women at high risk for preterm delivery
Magnetic resonance imaging of the cervix in women at high risk for preterm delivery
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DOI：
10.3109/14767058.2011.552654
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发表时间：
2011-11-01
影响因子：
1.8
通讯作者：
Irion, Olivier
中科院分区：
文献类型：
--
作者：
de Tejada, Begona Martinez;Faltin, Daniel L.;Irion, Olivier
目标.评估磁共振成像（MRI）上宫颈间质层信号强度的变化是否与自发性早产相关。妊娠18 - 34周因先兆晚期流产或早产而入院的女性的前瞻性队列研究。我们对100名妇女的子宫颈进行了T2加权低场MRI。子宫颈间质分化，定义为子宫颈内外层信号强度之间的对比，由对参与者临床报告不知情的放射科医生分类为高、中或低。主要的结局指标是自发性早产的比例。36名妇女发生自发性早产。高、中和低基质分化的自发性早产比例分别为7/24（29%）、21/64（33%;风险比1.1; 95%置信区间[CI]：0.6-2.3）和8/12（67%;风险比2.3; 95% CI：1.1-4.8）。当间质分化程度降低时，7天内分娩的风险增加，但差异无统计学意义。MRI显示宫颈间质分化程度低的妇女发生自发性早产的风险增加。这种风险也与宫颈长度短有关，通过阴道超声测量更容易且成本更低。
Objectives. To assess whether changes in signal intensity of cervical stroma layers on magnetic resonance imaging (MRI) are associated with spontaneous preterm delivery.Methods. Prospective cohort study of women admitted for threatened late miscarriage or preterm delivery between 18 and 34 weeks of gestation. We performed T2-weighted low-field MRI of the uterine cervix among 100 women. Cervical stromal differentiation, defined as the contrast between signal intensities of the inner and outer cervical layers, was classified as high, intermediate, or low by a radiologist blinded to the participant's clinical report. The main outcome measure was the proportion of spontaneous preterm delivery.Results. Thirty-six women had a spontaneous preterm delivery. The proportion of spontaneous preterm delivery for high, intermediate, and low stromal differentiation was 7/24 (29%), 21/64 (33%; risk ratio 1.1; 95% confidence interval [CI]: 0.6-2.3), and 8/12 (67%; risk ratio 2.3; 95% CI: 1.1-4.8), respectively. The risk of delivering within 7 days increased when stromal differentiation decreased, although the difference was not statistically significant.Conclusions. The risk of spontaneous preterm delivery is increased in women with low cervical stromal differentiation on MRI. This risk is also associated with short cervical length, a measurement easier and less costly to obtain by transvaginal ultrasound.