Quantitative assessment of cervical softening during pregnancy in the Rhesus macaque with shear wave elasticity imaging.
Quantitative assessment of cervical softening during pregnancy in the Rhesus macaque with shear wave elasticity imaging.
复制标题
DOI：
10.1088/1361-6560/aab532
复制
发表时间：
2018-04-19
影响因子：
3.5
通讯作者：
Hall TJ
中科院分区：
文献类型：
--
作者：
Rosado-Mendez IM;Carlson LC;Woo KM;Santoso AP;Guerrero QW;Palmeri ML;Feltovich H;Hall TJ
异常分娩，例如早产或过期分娩，与孕产妇和新生儿发病率和经济负担增加有关。这可能通过准确检测子宫颈的异常软化来预防。量化组织柔软度的剪切波弹性成像（SWEI）技术，如剪切波速度（SWS）测量，有希望用于评估宫颈。尽管如此，结果的解释可能会因生物变异性而复杂化（即，宫颈硬度的空间变化，产次），以及实验因素（即，传感器类型、扫描期间的姿势）。在这里，我们调查了SWEI检测宫颈软化的能力，以及SWS变异的来源，可以影响这项任务，在怀孕和非怀孕的恒河猴。具体来说，我们评估SWS的差异时，经腹与一个典型的线性阵列腹部探头，经直肠与原型腔内线性阵列探头成像宫颈。使用线性混合效应（LME）模型对SWS作为月经周期日（非妊娠动物）和胎龄（妊娠动物）的函数进行建模。其他变量包括产次、剪切波方向和宫颈侧（前与后）。在非妊娠子宫颈中，LME模型表明SWS每天增加2%（95%置信区间0-3%），从月经前8天开始。妊娠期间，SWS以每周6%（95%CI 5-7%）（腔内方法）和每周3%（95%CI 2-4%）（经腹方法）的速率显著降低，扫描方法与其他固定效应之间的相互作用也很显著。这些结果表明，虽然绝对SWS值受扫描方法和SWEI实施等因素的影响，但这些变异性来源不会影响SWEI对宫颈软化的敏感性。我们的研究结果还强调了标准化SWEI方法以提高宫颈评估准确性的重要性。
Abnormal parturition, e.g. pre- or post-term birth, is associated with maternal and neonatal morbidity and increased economic burden. This could potentially be prevented by accurate detection of abnormal softening of the uterine cervix. Shear Wave Elasticity Imaging (SWEI) techniques that quantify tissue softness, such as shear wave speed (SWS) measurement, are promising for evaluation of the cervix. Still, interpretation of results can be complicated by biological variability (i.e., spatial variations of cervix stiffness, parity), as well as by experimental factors (i.e., type of transducer, posture during scanning). Here we investigated the ability of SWEI to detect cervical softening, as well as sources of SWS variability that can affect this task, in the pregnant and nonpregnant Rhesus macaque. Specically, we evaluated SWS differences when imaging the cervix transabdominally with a typical linear array abdominal transducer, and transrectally with a prototype intracavitary linear array transducer. Linear mixed effects (LME) models were used to model SWS as a function of menstrual cycle day (in nonpregnant animals) and gestational age (in pregnant animals). Other variables included parity, shear wave direction, and cervix side (anterior vs. posterior). In the nonpregnant cervix, the LME model indicated that SWS increased by 2% (95% Confidence Interval 0-3%) per day, starting 8 days before menstruation. During pregnancy, SWS signicantly decreased at a rate of 6% (95% CI 5-7%) per week (intracavitary approach) and 3% (95% CI 2-4%) per week (transabdominal approach), and interactions between the scanning approach and other fixed effects were also significant. These results suggest that, while absolute SWS values are influenced by factors such as scanning approach and SWEI implementation, these sources of variability do not compromise the sensitivity of SWEI to cervical softening. Our results also highlight the importance of standardizing SWEI approaches to improve their accuracy for cervical assessment.
登录
查看更多内容
影响因子：
5.5
作者：
HARKNESS, MLR;HARKNESS, RD
通讯作者：
HARKNESS, RD
影响因子：
5.8
作者：
HALUSKA, GJ;WEST, NB;BRENNER, RM
通讯作者：
BRENNER, RM
影响因子：
2.9
作者：
Ferraioli, Giovanna;Filice, Carlo;Kudo, Masatoshi
通讯作者：
Kudo, Masatoshi
影响因子：
1.7
作者：
HAFEZ E S E;JASZCZAK S
通讯作者：
JASZCZAK S
影响因子：
9.7
作者：
Myers, K. M.;Paskaleva, A. P.;Socrate, S.
通讯作者：
Socrate, S.