The diagnostic value of two-dimensional shear wave elastography in gestational diabetes mellitus

The aim of our study is to establish the reference range of Young's modulus values of placenta in normal pregnancies and to evaluate the diagnostic value of two-dimensional shear wave elastography (2D-SWE) in gestational diabetes mellitus (GDM).

A total of 223 normal pregnant women, 22 pregnancies complicated by A1GDM (controlled by diet), and 14 pregnancies complicated by A2GDM (controlled by medication) were recruited for this study. The elasticity values of the central parts of the placentas were determined by 2D-SWE imaging. The mean value (E_mean), min value (E_min), and max value (E_max) of the placentas were recorded. Twenty placentas were randomly selected for reliability analysis.

(1) All values (E_mean, E_min, E_max) showed great repeatability and consistency. (2) The reference range of Young's modulus values of placentas in normal pregnancies were E_mean (4.12 ± 0.83), E_min (2.15 ± 0.83) and E_max (6.72 ± 1.43). No significant correlations were observed between elasticity values and gestational age (r < 0.3, p > 0.05) or between elasticity values and placental maturity (r < 0.3, p > 0.05). (3) The Young's modulus values in the A1 GDM and A2 GDM women were E_mean (6.39 ± 1.74), E_min (2.95 ± 1.05), E_max (10.78 ± 2.94) and E_mean (11.96 ± 7.29), E_min (6.79 ± 4.70a), E_max (18.94 ± 11.61) respectively. All values were significantly higher in GDM pregnancies than in normal pregnancies (p < 0.05). A2GDM pregnancies had higher values than A1GDM pregnancies (p < 0.05).

Placental elasticity is independent of gestational age and placental maturity. 2D-SWE can play an important role in diagnosing GDM by assessing placental hardness.