Repeatability and reproducibility of quantitative cervical strain elastography (E-Cervix) in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Biomedical Engineering

Background:

• Strain elastography of the uterine cervix shows promise for diagnosing obstetric complications.
• Previous limitations included the inability to obtain quantitative results, relying only on semiquantitative visual evaluation.
• E-Cervix software enables quantitative parameter evaluation using intrinsic compression and pixel distribution analysis.

Purpose of the Study:

• To assess the repeatability and reproducibility of quantitative cervical strain elastography (E-Cervix).
• To evaluate the correlation between quantitative elastographic parameters and clinical features in pregnant patients during the third trimester.

Main Methods:

• 222 patients in their third trimester of pregnancy were studied.
• Five ultrasound parameters were assessed: elasticity index (ECI), hardness ratio (HR), internal os strain (IOS), external os strain (EOS), and IOS/EOS ratio.
• A standardized protocol was followed for all quantitative elastographic assessments.

Main Results:

• Good intra- and interobserver reproducibility was achieved for all assessed elastographic parameters (ICC range: 0.771–0.838).
• Significant, though very low, correlations were found between some parameters and clinical features like patient age, previous Cesarean sections, pregnancy weight, and BMI.
• Quantitative assessment using E-Cervix exhibited good repeatability.

Conclusions:

• Quantitative cervical strain elastography with E-Cervix is a repeatable method for evaluating the uterine cervix.
• Certain clinical features may minimally influence the obtained parameters, but their clinical relevance requires further investigation.
• This quantitative approach offers a reliable tool for potential use in diagnosing obstetric complications.