Cervical ultrasound elastography may hold potential to predict risk of preterm birth

Freehand ultrasound real-time elastography (RTE) is a simple technique allowing direct visualization of the elastogramme superimposed on the B-mode -image. The objective of RTE is to investigate stiffness and related parameters such as local tissue strain with a view to adding new information related to tissue morphology and architecture.

This was a pilot study in 12 healthy pregnant women who underwent transvaginal ultrasound. The RTE (Hitachi) information was colour-coded and superimposed on the B-mode scan. Elastography images were analyzed by means of a software tool to identify thresholds for the colours red (soft), green (medium hard) and blue (hard). The cervical strain rate was measured in three different parts. Additional information obtained included age of gestation, number of pregnancies and deliveries, previous preterm births and gestational age at delivery in current pregnancy.

The softness of cervix increases towards portio. Within the colour spectrum, green was predominant. Strain ratio can be used as a comparative index among different subjects rather than as an absolute strain measurement.

The elastographic image allowed for easy correlation between colour distribution and the anatomical structures as it is superimposed on the B-mode image. The elasticity of the cervix increases towards portio.

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