| 摘要: |
| 目的 探讨E-cervix弹性成像技术评估宫颈成熟度及预测阴道分娩的临床价值。方法 选取在我院生产的87例足月孕妇，根据分娩情况分为顺产组（61例）和剖宫产组（26例）。经阴道超声检查，应用E-cervix弹性成像技术测量宫颈弹性参数，包括硬度比值（HR）、弹性对比指数（ECI）、宫颈内外口应变值（IOS、EOS）及宫颈内外口应变比值（IOS/EOS）；均行Bishop评分，测量其宫颈长度。比较两组律宫缩前后宫颈各参数的差异，绘制受试者工作特征（ROC）曲线分析宫颈各参数预测阴道分娩的截断值及其效能。结果 两组Bishop评分、HR、IOS、EOS比较差异均有统计学意义（均P＜0.05），宫颈长度、ECI、IOS/EOS比较差异均无统计学意义。其中18例孕妇在规律宫缩开始及宫颈扩张之间进行了再次评估，仅顺产组在规律宫缩前后HR、IOS、EOS比较差异均有统计学意义（均P＜0.05）。ROC曲线结果显示，HR预测阴道分娩效能最佳，AUC为0.84，截断值为51.94%，优于宫颈长度及Bishop评分。结论 E-cervix弹性成像技术可较为客观、便捷、准确地反映孕晚期宫颈的变化情况，对临床评估宫颈成熟度有一定价值。 |
| 关键词: 弹性成像 宫颈成熟度 宫颈长度 Bishop评分 |
| DOI： |
| 投稿时间：2021-03-19修订日期：2021-11-23 |
| 基金项目: |
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| The clinical value of E-cervix elastography for assessing cervical maturity in late pregnancy |
| Shu Yang,Luo Xiaodong,Wang Zhigang |
| (Institute of Ultrasound Imaging,Chongqing Medical University;Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Chongqing Medical University) |
| Abstract: |
| Objective To explore the clinical value of E-cervix elastography technology in assessing cervical maturity and predicting vaginal delivery Methods The 87 full-term pregnant women who gave birth in our hospital were selected and divided into spontaneous vaginal delivery group (61 cases) and the cesarean section group (26 cases) according to the delivery conditions. Transvaginal ultrasound examination, using E-cervix elastography technology to measure cervical elastic parameters, including stiffness ratio (HR), elastic contrast index (ECI), cervical internal and external oral strain values (IOS, EOS) and cervical internal and external oral strain ratio (IOS/ EOS). Bishop score and cervical length were measured. The differences of cervical parameters before and after contraction between the two groups were compared, and the receiver operating characteristic (ROC) curve was used to analyze the cut-off value of each parameter of the cervix in predicting vaginal delivery and its efficacy. Results The Bishop score，HR，IOS and EOS were statistically significant differences between the two groups（all P< 0.05）.However，there were no significant differences in CL，ECI and IOS/EOS between the two groups. Among them, 18 pregnant women were reassessed between the onset of regular contractions and cervical dilation. Only the spontaneous vaginal delivery group had statistically significant differences in HR, IOS, and EOS before and after regular contractions (all P<0.05). ROC curve results show that HR was the most sensitive in predicting vaginal delivery, with an AUC of 0.84 and a cut-off value of 51.94%, which is better than cervical length and Bishop score. Conclusion E-cervix elastography technology may objectively，conveniently and accurately show the changes of the cervix in full-term of pregnancy，and can be used as a valuable tool to evaluate cervical maturation. |
| Key words: Elastography Cervical maturation Cervical length Bishop score |
