Three-Dimensional, Extended Field-of-View Ultrasound Method for Estimating Large Strain Mechanical Properties of the Cervix during Pregnancy
Three-Dimensional, Extended Field-of-View Ultrasound Method for Estimating Large Strain Mechanical Properties of the Cervix during Pregnancy
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DOI：
10.1177/016173461203400101
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发表时间：
2012-01-01
影响因子：
2.3
通讯作者：
Socrate, Simona
中科院分区：
文献类型：
--
作者：
House, Michael;Feltovich, Helen;Socrate, Simona
宫颈缩短和宫颈机能不全是导致早产的重要原因。然而，控制子宫颈如何从长而闭合变为短而扩张的变形机制尚不清楚。生物力学问题的研究受到以下限制：（1）缺乏与颈椎变形相关的三维解剖学变化的彻底表征;（2）难以在体内测量颈椎组织特性。本研究的目的是探讨使用三维超声和宫底压力，以获得解剖学上准确的数值模型的大应变在怀孕期间的宫颈变形，使非侵入性评估宫颈组织的顺应性的可行性。研究了健康受试者（n=6）和1例妊娠中期急性宫颈机能不全受试者。获得整个子宫和宫颈的扩展视野超声图像。这些图像有助于构造解剖学上精确的数值模型。子宫颈负荷是通过子宫底压力来实现的，子宫底压力通过阴道压力导管来量化。在一个主题中，解剖结构对眼底压力的反应是匹配的基于模型的模拟的变形反应，从而得出相应的颈椎力学性能和显示的可行性，非侵入性评估的顺应性。这项初步研究的结果表明，生物力学建模框架的可行性，估计在体内颈椎力学性能。提高对颈椎生物力学功能的认识将有助于阐明颈椎短缩的病理生理学机制。
Cervical shortening and cervical insufficiency contribute to a significant number of preterm births. However, the deformation mechanisms that control how the cervix changes its shape from long and closed to short and dilated are not clear. Investigation of the biomechanical problem is limited by (1) lack of thorough characterization of the three-dimensional anatomical changes associated with cervical deformation and (2) difficulty measuring cervical tissue properties in vivo. The objective of the present study was to explore the feasibility of using three-dimensional ultrasound and fundal pressure to obtain anatomically-accurate numerical models of large-strain cervical deformation during pregnancy and enable noninvasive assessment of cervical-tissue compliance. Healthy subjects (n=6) and one subject with acute cervical insufficiency in the midtrimester were studied. Extended field-of-view ultrasound images were obtained of the entire uterus and cervix. These images aided construction of anatomically accurate numerical models. Cervical loading was achieved with fundal pressure, which was quantified with a vaginal pressure catheter. In one subject, the anatomical response to fundal pressure was matched by a model-based simulation of the deformation response, thereby deriving the corresponding cervical mechanical properties and showing the feasibility of noninvasive assessment of compliance. The results of this pilot study demonstrate the feasibility of a biomechanical modeling framework for estimating cervical mechanical properties in vivo. An improved understanding of cervical biomechanical function will clarify the pathophysiology of cervical shortening.