A novel method for evaluating uterine cervical consistency using vaginal ultrasound gray-level histogram
A novel method for evaluating uterine cervical consistency using vaginal ultrasound gray-level histogram
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DOI：
10.1515/jpm.2010.079
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发表时间：
2010-09-01
影响因子：
2.4
通讯作者：
Suzuki, Mitsuaki
中科院分区：
文献类型：
--
作者：
Kuwata, Tomoyuki;Matsubara, Shigeki;Suzuki, Mitsuaki
目的：利用阴道超声灰度直方图评价宫颈一致性。方法：对214例妊娠27-30周的低危单胎妊娠妇女进行阴道超声和指检。在颈前壁和后颈壁的中部测量超声灰度直方图的平均灰度（MGL），代表感兴趣区域的回声性。前侧和后侧之间的 MGL 差异（AP 差异）与超声前确定的颈椎一致性 Bishop 子评分（0、1 或 2）相关。结果：较大的阳性 AP 差异表明 Bishop 子评分显着较低。分析接收者操作员特征曲线的 AP 差异后，1.42 和 -1.98 的值分别是确定硬子宫颈（得分 0）和软子宫颈（得分 2）的最佳截止值。为了识别硬子宫颈，该测试的敏感性为 71%，特异性为 82%。对于软子宫颈，分别为66%和87%。结论：子宫颈前部回声强于子宫颈后部，表明子宫颈硬；子宫颈后部回声强，则子宫颈硬。前壁和后壁之间的回声差异越大，子宫颈就越硬。超声灰度直方图MGL的差异可以客观评价宫颈一致性。
Aims: To evaluate uterine cervical consistency using a vaginal ultrasound gray-level histogram.Methods: Vaginal ultrasound and digital examination were performed for 214 women with low-risk singleton pregnancy during 27-30(th) pregnancy week. The mean gray-level (MGL) of an ultrasound gray-level histogram, representing the echogenicity of a region of interest, was measured in the midsection of anterior and posterior cervical walls. The difference in MGL between anterior and posterior (AP difference) was related to the Bishop sub-score for cervical consistency (0, 1, or 2), determined before ultrasound.Results: A larger positive AP difference indicated significantly lower Bishop sub-score. After analyzing the receiver operator characteristic curves for the AP difference, a value of 1.42 and -1.98 was the best cut-off value to determine a hard cervix (score 0) and a soft cervix (score 2), respectively. To identify a hard cervix, this test had 71% sensitivity and 82% specificity. For a soft cervix, it was 66% and 87%, respectively.Conclusions: A more echogenic anterior than posterior cervix indicates a hard cervix; the greater the difference in echogenicity between anterior and posterior walls the harder the cervix. The difference in MGL of the ultrasound gray-level histogram may enable objective evaluation of cervical consistency.